TITLE:
Study of Prevalence of Abnormal Cervical Cytology in Al-Shatby Maternity University Hospital
AUTHORS:
Ahmed Essmat, Mahmoud Meleis, Hossam Elsokkary, Sanna Shawky Ahmed, Enas El-Soody
KEYWORDS:
Abnormal Cervical Cytology, Bethesda System, Cervical Cancer Screening, Pap Smear, Preinvasive Cervical Cancer
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.4,
April
26,
2021
ABSTRACT: Introduction:
Cervical cancer is the most common cause of preventable cancer related deaths; cervical cancer has a long pervasive phase (cervical
dysplasia); the prevalence of cervical dysplasia varies according to the
socioeconomic characteristics and geographic
areas of the population studied. Low-grade lesions regress spontaneously
in a significant number of patients, while high grade lesions will progress to
an invasive cancer if left untreated. Cervical cancer screening is an important
component of the World Health Organization (WHO) strategy for combating
cervical cancer. The incidence and prevalence of cervical cancer has reduced
remarkably over the last three decades in developed countries where there are
effective, well-coordinated screening programs, and treatment of cervical
dysplasia, while in developing countries it has been increasing and has
constituted major health problems among women
where there are no well-coordinated and effective screening programs,
also resources are very low and no insurance can cover this programs. Aim of
the work: The aim is to assess the prevalence of abnormal cervical cytology in
Al Shatby Maternity University Hospital patients using Pap smear. Materials and
methods: Inclusion criteria: 1) Married woman from 3 years or more; 2) Women
age from 21 to age 65 years. Exclusion criteria: 1) Previously known cervical
cancer patient; 2) Virgin females; 3) Woman with active vaginal bleeding.
Results: 83% of patients were -ve intraepithelial neoplasia {37.7% was
normal cytology and 45.3% was inflammatory}. 17% was +ve intraepithelial
neoplasia (abnormal cytology), {11.1% ASCUS, 2.9% LSIL, 1.3% HSIL, 1.1% ASC-H,
0.3% AGS-NO, 0.3% AGS-Favour Neoplastic}. Prevalence of abnormal cervical
cytology in age group less than30 years was 8.4% which is lower than prevalence
in the middle age group which was 19.9%. Prevalence of abnormal cervical
cytology in women with normal vaginal delivery was higher than those with
caesarean delivery. 39.8% of our patients were passive and active smokers 61.2%
of their Pap smear was abnormal cytology. 78.9% of abnormal cytology was among patients from low socioeconomic class
(rural areas). Abnormal cervical
cytology in patients with high parity was 69% which is higher than
abnormality found in lower parity. 60.2% of abnormal cervical cytology was in
patients who became sexually active before age of 20 years. Prevalence of
abnormal cervical cytology was higher in patients with multiple sexual partners
(56.5%) than patients with single sexual partner (13.3%). Conclusion: Cervical
cytology remains the gold standard for cervical cancer screening and the use of
Bethesda system is a simple and accurate method for diagnosis and management of
cases with abnormal cervical cytology.