‘PAP SMEAR’ FOR SCREENING OF PRECANCEROUS CONDITIONS OF CERVIX
AbstractBackground: Cervical intra-epithelial neoplasia (CIN) and cervical cancer remain important healthproblems for women worldwide. It is largely a preventable disease that is characterised by a long leadtime. The objective of this study was to determine the frequency of precancerous conditions of cervix(CIN I–III) in women with chronic vaginal discharge by Pap smear screening. Methods: The study wasconducted at the outpatient department of Obstetric and Gynaecology, Nishtar Hospital Multan, andMultan Institute of Nuclear Medicine & Radiotherapy (MINAR) from February 2009 to February 2010.Two hundred and eighty patients with complaint of chronic vaginal discharge were selected. Theirdetailed history was documented on a Proforma, Pap smear taken at MINAR, and samples sent topathology department of Nishtar Hospital Multan for cytological examination. All mild dyskaryosis orCIN I cases were advised follow-up with repeat Pap smear in 6–12 months and those with moderate tosevere neoplasia (CIN II–III) were further investigated by cervical biopsy and managed accordingly.Results: Of the total, 100 patients were between 25–30 years of age, and 180 between 31–35 years ofage. Mean age of patients was 31.6 years, mean age at marriage 21.7 years, and mean parity was 3.6.Most of the patients (67.9%) belonged to low socioeconomic status. The cytological examination of thesmears showed no changes (normal) in 100 (35.7%) cases, while 156 (55.7%) cases showedinflammatory changes, 10 (3.6%) showed dysplastic changes, of whom 8 cases had CIN-I (2.8%) andone case was of CIN-II (0.4%). One was having CIN-III/severe dysplasia (0.4%). Inadequate sample wasreported in 14 (5%) cases. Conclusion: Pap smear should be used as a routine test for all sexually active,young females presented to the gynaecology outpatient department, for early detection of cervical precancer (CIN) as it is not uncommon in our set up.Keywords: Pap smear, Cervical Intraepithelial Neoplasia, CIN, cervical, Screening Program
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