PAP SMEAR IS A TOOL IN FIGHT: PAP SMEAR AS A SCREENING MODALITY FOR CERVICAL CANCER

Dr. Garima Yadav, Dr. Zakia Rahman

Abstract


Objective: To investigate the prevalence of abnormal Papanicolou smear collected from cytology laboratory. These samples have been taken from the women who attended the gynecological clinics and opportunistic screening done.

Material and methods:Source of Data: Paper smear collection was done in Kamla Raja Madhav Dispensary OPD, G.R. Medical College & J.A. Group of Hospitals, Gwalior (M.P.). Methods of collection of Data: A prospective study with study period of 18 months. Sample size was 500 cases who fulfilled selection criteria. Inclusioncriteria:1. Recurrent episodes of white discharge per vagina, 2. Intermenstrual bleeding, post-coital bleeding or post menopausal bleeding, 3. Suspicious looking cervix (leukoplakia, cervical ectopy etc.). Exclusion criteria:1. Pregnant women, 2. Clinically visible growth on cervix, 3. Unmarried

Procedure: Written and informed consent were obtained from all the participants after brief explanation of the procedure.

Results:Maximum cases (65%) were from rural area.Majority of the study group were Para 2 (27%) and para 3 (29%) Severity of cervical lesions increased with higher parity. Mean age of marriage was 17.8(2.4) years. Maximum no. of high grade preinvasive (25%) and invasive lesion (1.2%) were found in women married before18 years. Dysplasia and malignancy were significantly associated with consummation of marriage at early age. Non users of contraceptive were associated with high incidence of high grade preinvasive lesion (32%) & invasive lesion (1.2%). Leucorrhea was the leading clinical complaint (80%) while erosion of cervix was the commonest clinical finding. Overall incidence of CIN ( cervical intraepithelial neoplasia) was 44.5%. CIN-I was found in 24%,CIN-II in 14%, CIN-III in 6.5% and invasive carcinoma in 0.8%.

Conclusion:Low educational level and low socioeconomic status leading to poor genital hygiene, marital status and early age of marriage explaining earlier and longer sexual life, high parity with unattended delivery and presence of infection were the main contributing factors for incidence of dysplasia and invasive carcinoma.


Keywords


Pap smear, dysplasia, preinvasive lesions, CIN, carcinoma

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References


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