Pattern Of Epithelial Cell Abnormalities On Cervical Papanicolaou Smears In Hospital Of North India: A Retrospective Study.
Keywords:
Pap smear screening, epithelial cell abnormalities, cancer cervix, The Bethesda system.Abstract
Introduction: Cervical cancer is the most common cancer of the female genital tract .India accounts for 25% of the cervical cancer deaths and the incidence is about 23.29%. Pap smear test is considered to be most important test for screening of cervical cancers and is regarded as gold standard for screening program.
Materials and Methods: A retrospective study was carried  in Department of Pathology of a Hospital of North India, from June 2014 to Jan2017.Total of 1534 samples were screened. We followed The Bethesda system2014 for reporting the Pap smears.
Results: Â Out of 1534 samples, 4.8% were unsatisfactory, 90.6% were NILM, 1.4% were ASCUS, 0.8%each were LSIL, HSIL, and Squamous Cell Carcinoma 0.26% each were AGCUS and ASCH. The commonest age group affected was 30 -50 years.
Conclusion: Pap Screening should focus on the peri -menopausal and the post- menopausal Group as in our study we found that most of the patients belonged to this age group.
DOI:10.21276/APALM.1726
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17. The Bethesda System for Reporting Cervical Cytology. Definitions, Criteria and Explanatory Notes. Editors: Nayar Ritu, Wilbur, David (Eds).
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25. Geethu G. Nair et al Cytopathological pattern of cervical pap smears - a study among population of North Malabar in Kerala Indian Journal of Pathology and Oncology, October-December 2016;3(4);552-557.
26. Bukhari MH, Saba K, Qamar S, Majeed MM, Niazi S, Naeem S. Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix. Journal of Cytology 2012; 29:20-5.
27. Beevi NA, Sreenivas S. Awareness of cervical cancer and Pap smear and it’s utilization among health care workers in medical college, Kozhikode. Journal of evidence based medicine and health care.2014; 1:12-7.
28. Mulay K, Swain M, Patra S, Gowrishankar S. A comparative study of cervical smears in an urban Hospital in India and a population-based screening program in Mauritius. Indian Journal of Pathology and Microbiology 2009; 52:34-7. 19
29. Misra JS, Srivastava S, Singh U, Srivastava AN. Risk factors and strategies for control of carcinoma cervix in India: hospital based cytological screening experience of 35 years. Indian Journal of Cancer 2009; 4:155-9.
30. Bal MS, Goyal R, Suri AK, Mohi MK. Detection of abnormal cervical cytology in Papanicolaou smears. Journal of Cytology. 2012; 29:45-7.
31. Sarma U, Mahanta J, Talukdar K. Pattern of Abnormal Cervical Cytology in women attending a Tertiary Hospital. International Journal of Scientific and Research Publications 2012; 2 :4pages.
32. Gupta K, Malik NP, Sharma VK, Verma N, Gupta A. Prevalence of cervical dysplasia in western Uttar Pradesh. Journal of Cytology 2013; 30:257-62.
33. Kothari S, Gohel A, Dayal A, Shah R, Patel S. Pap smear - A tool for detection of cervical intraepithelial lesions in health checkup schemes: A study of 36,740 cases. International Journal of Research Medicine. 2014; 3:12-5.
34. Katheit G, Tiwari S. Cytological pattern and demographic determinants of cervical cytology (Papanicolaou smear) in a tertiary center of central India. European journal of biomedical & pharmaceutical sciences 2015; 2:1402-9.
35. Shashidhar MR, Jayasheelan. Prevalence of cervical cancer and role of screening programs by PAP Smears. International Journal of Pathology, 2017; 1(2):32-36
2. ICO Information Centre on HPV and Cancer. (Summary Report 2014.08.22). Human Papillomavirus and related Diseases in India. Human Papillomavirus and Related Diseases Report.
3. K. Park, Park’s Textbook of Preventive and Social Medicine .24th edition. Banarsidas Bhanot Publishers, (2017).
4. Shanta V, Krishnamurthi S, Gajalakshmi CK, Swaminathan R, Ravichandran K. Epidemiology of Cancer of the Cervix: Global and national perspective. Journal of Indian Medical Association.2000, 98(2):49-52
5. Patel MM, Pandya AN, Modi J. Cervical Pap smear study and its utility in cancer screening, to specify the strategy for cervical cancer control. Natl J Com Med 2011; 1:49– 51.
5. Cheryl LR, Clair WM, Kevin R et al. prevention of cervical cancer. Critical review in Oncology / Hematology; 2000: 33: 169-185.
6. Ali F, Kuelker R, Wassie B. Understanding cervical cancer in the context of developing countries. Ann Trop Med Public Health 2012; 5:3-15.
7. Denny L. The Prevention of Cervical Cancer in developing countries. British Journal of Obstetrics and Gynecology 2005; 112:1204–12.
8. Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education, and Research, Chandigarh, India. Guidelines for Cervical Cancer Screening Program.
9. Solomon D, Nayar R, editors. The Bethesda System for reporting cervical cytology: defintions, criteria, and explanatory notes. New York: Springer-Verlag; 2004.
10. Nayar R, Wilbur DC, editors. The Bethesda System for reporting cervical cytology: defintions, criteria, and explanatory notes. Springer, 2015.
11. Paulin H, Geldenhuys L, Naugler C. Predictors of an Unsatisfactory Conventional Cervical Cytology Smear. Journal Obstet Gynaecol Can 2011; 33(7):725–728
12. Marahatta R, Bhattarai S. Value of conventional cervical cytology as a screening test for cervical cancer. Nepal Medical College Journal. 2013; 15(2) 223.
13. Afrakhteh M, Khodakarami N, Moradi A, Alavi E, Shirazi F H. A study of 13315 papanicolaou smear diagnoses in Shohada Hospital. Journal of Family Reproduction and Health 2007; 1:74–8.
14. Izabela T. Burja, Sophie K. Thompson. Atypical glandular cells of undetermined significance on cervical smears. Acta cytologica; vol.43, no. 3: 1999: 357-56.
15. Gerber S, De Grandi P, Petignat P. Colposcopic evaluation after a repeat atypical squamous cells of undetermined significance (ASCUS) smear. International Journal Gynaecol obstet. 2001; 75:251-255.
16. Guerrini L, Sama D, Visani M. Is it possible to define a better ASCUS class in cervicovaginal screening?†Acta Cytologica, Vol.45, no.4, pp.532-536, 2001.
17. The Bethesda System for Reporting Cervical Cytology. Definitions, Criteria and Explanatory Notes. Editors: Nayar Ritu, Wilbur, David (Eds).
19. Barcelos A, Michelin M, Adad S, Murta E. Atypical Squamous Cells Of Undetermined Significane: Bethesda Classification and Association with Human Papillomavirus. Infectious Diseases in Obstetrics and Gynecology.Volume2011(2011), Article ID 904674, 9pages
20. Emerging issues on HPV infections: from Science to Practice. Editor, Joseph Monsonego. Karger Medical and Scientific Publishers, Jan 2006.
21. Nasimento A, Cibas ES. The ASC/SIL Ratio for Cytopathologists as a Quality Control Measure. A Follow –up Study. American Journal of Pathology 2007; 128:653-656.
22. Juskevicius R, ZouKH, CibasES.An analysis of factors that influence the ASCUS/SIL ratio of pathologists. American Journal of Clinical Pathology. 2001;116(3):331-5
23. Stoler MH, Schiffman M; Atypical Squamous Cells of Undetermined Significance- Low-grade Squamous Intraepithelial Lesion Triage Study (ALTS) Group. JAMA.2001 Mar 21; 285(11):1500-5.
24. Massad L.S, Einstein M.H, Huh W.K., Katki H. A., Kinney W. K., Schiffman M., Solomon D, Wentzensen N., Lawson H. W. 2012 ASCCP Consensus Guidelines Conference. 2012updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet. Gynecol.2013; 121:829-846.
25. Geethu G. Nair et al Cytopathological pattern of cervical pap smears - a study among population of North Malabar in Kerala Indian Journal of Pathology and Oncology, October-December 2016;3(4);552-557.
26. Bukhari MH, Saba K, Qamar S, Majeed MM, Niazi S, Naeem S. Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix. Journal of Cytology 2012; 29:20-5.
27. Beevi NA, Sreenivas S. Awareness of cervical cancer and Pap smear and it’s utilization among health care workers in medical college, Kozhikode. Journal of evidence based medicine and health care.2014; 1:12-7.
28. Mulay K, Swain M, Patra S, Gowrishankar S. A comparative study of cervical smears in an urban Hospital in India and a population-based screening program in Mauritius. Indian Journal of Pathology and Microbiology 2009; 52:34-7. 19
29. Misra JS, Srivastava S, Singh U, Srivastava AN. Risk factors and strategies for control of carcinoma cervix in India: hospital based cytological screening experience of 35 years. Indian Journal of Cancer 2009; 4:155-9.
30. Bal MS, Goyal R, Suri AK, Mohi MK. Detection of abnormal cervical cytology in Papanicolaou smears. Journal of Cytology. 2012; 29:45-7.
31. Sarma U, Mahanta J, Talukdar K. Pattern of Abnormal Cervical Cytology in women attending a Tertiary Hospital. International Journal of Scientific and Research Publications 2012; 2 :4pages.
32. Gupta K, Malik NP, Sharma VK, Verma N, Gupta A. Prevalence of cervical dysplasia in western Uttar Pradesh. Journal of Cytology 2013; 30:257-62.
33. Kothari S, Gohel A, Dayal A, Shah R, Patel S. Pap smear - A tool for detection of cervical intraepithelial lesions in health checkup schemes: A study of 36,740 cases. International Journal of Research Medicine. 2014; 3:12-5.
34. Katheit G, Tiwari S. Cytological pattern and demographic determinants of cervical cytology (Papanicolaou smear) in a tertiary center of central India. European journal of biomedical & pharmaceutical sciences 2015; 2:1402-9.
35. Shashidhar MR, Jayasheelan. Prevalence of cervical cancer and role of screening programs by PAP Smears. International Journal of Pathology, 2017; 1(2):32-36
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22-03-2018
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Singhal U, Lamba S, Kumar U, Nanda A. Pattern Of Epithelial Cell Abnormalities On Cervical Papanicolaou Smears In Hospital Of North India: A Retrospective Study. Ann of Pathol and Lab Med [Internet]. 2018 Mar. 22 [cited 2025 May 13];5(3):A250-255. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm1726
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