DETECTION OF ABNORMAL CERVICAL CYTOLOGY BY PAP SMEARS

Background: Cervical intra-epithelial neoplasia and cervical cancer remain important health problems for women worldwide. Cervical cytology by Papanicolaou stained smears is an effective means of screening for cervical pre-malignant and malignant conditions. This study was designed to determine the prevalence of cervical intra epithelial neoplasia in this region and the role of pap smears for its detection. Material and Methods: It was hospital based study on patients who attended the Out Patient Department of Lady Reading Hospital, Peshawar, Pakistan, from January to September 1997. Patients presenting with vaginal discharge, dyspareunia, post-coital bleeding, backache or pain hypogastrium were included. Patients having vaginal bleeding other than post-coital, were excluded from the study. Relevant information was obtained from the patients and recorded. Samples were collected and transferred to glass slides, fixed and stained by Papanicolaou stain. Each slide was carefully examined. Results: Three hundred patients were included in this study. One hundred and twenty three (41%) patients had complaints of vaginal discharge, 39 (13%) post-coital bleeding, 108 (36%) dyspareunia and 30 (10%) backache /or pain hypogastrium. Regarding contraception, 37 (12.33%) patients were pill users, 31 (10.33%) were on injectable contraceptives, 32 (10.67%) were using barrier method of contraception, 34 (11.33%) patients were having an intrauterine contraceptive device and 160 (55.33%) patients were not using any method of contraception. Pap smears revealed that 8 (2.67%) patients were having cervical intra-epithelial neoplasia. Among these patients, 1 (12%) had intra-uterine contraceptive device, 3 (38%) were on oral contraceptive pill, while 4 (50%) were not using any contraceptive method. One hundred and seventy eight (59.33%) patients were having past history of genital infection where as 128 (42.67%) patients had no such history. Age at first coitus was below 20 years in 268 (89.33%) patients whereas it was above 20 years in only 32 (10.67%) patients. All these patients belonged to poor socio-economic class. Conclusion: Cervical intra epithelial neoplasia is not uncommon in our set up. It can be diagnosed early by Pap smears.