Aims and Objective: Worldwide, cervical cancer is the 2nd most common cancer in women. 80% of all the cases of cervical cancer occur in the developing countries. Cervicovaginal cytology (Pap) is an effective means of screening for cervical lesions. The aim is to study the spectrum of squamous epithelial lesions and their prevalence among different age groups. cervical cancer is the second most common cancer among the women in the developing countries (India). This is a Prospective, hospital based study done in a hospital at NMCH, Patna and carried for a period of two year.

Material and Methods: The patients presenting with complaints of vaginal discharge, backache, pain hypogastrium, dyspareunia and post coital bleeding were included in the study. Unsatisfactory smears, age <18 yrs, pregnancy, women who underwent hysterectomy, women with vaginal bleeding were excluded. The smears were reported according to the 2001 Bethesda system.

Result: Out of 220 cases, 240(91.95%) were reported as Negative for intraepithelial lesion and 21(8.04%) cases were found to be abnormal pap smears - 15(5.74%) cases of LSIL, 2(0.76%)  cases of HSIL and 4(1.53%) cases of ASCUS . Their prevalence among different age groups was - 161(61.68%) in reproductive age group, 55(21%) in perimenopausal age group and 45(17.24%) in postmenopausal age group. Abnormal cervical lesions can be diagnosed early by Pap smear examination. The prevalence of the abnormal smears was found to be more among perimenopausal age group followed by postmenopausal and then the reproductive age groups.

Conclusion: Abnormal cervical lesions are not uncommon and it can diagnose early by Pap smear examination

Keywords: Cervicovaginal cytology, Papanicolaou stain, Pap smear, Abnormal cervical lesions, Screening.

1. Bray F, Ferlay J, Parkin DM, Pisani P. GLOBOCAN 2000: cancer incidence, mortality and prevalence worldwide. In GLOBOCAN 2000: cancer incidence, mortality and prevalence worldwide 2001 (pp. 1-CD).
2. Khattak ST, Naheed T, Akhtar S, Jamal T. Detection of abnormal cervical cytology by pap smears. Gomal Journal of Medical Sciences. 2004 Jun 1; 4(2).
3. Solomon D, Davey D, Kurman R, Moriarty A, O'Connor D, Prey M, Raab S, Sherman M, Wilbur D, Wright Jr T, Young N. The 2001 Bethesda System: terminology for reporting results of cervical cytology. Jama. 2002 Apr 24; 287(16):2114-9.
4. Ranabhat SK, Shrestha R, Tiwari M. Analysis of abnormal epithelial lesions in cervical Pap smears in Mid-Western Nepal. Journal of Pathology of Nepal. 2011; 1(1):30-3.
5. Zamani N. Management of abnormal cervical cytology. J coll physc surg pak 1994; 4: 28-29.       
6. Yousaf A, Yousaf NW. Review of cervical intra epithelial neoplasia (CIN) latest concepts of screening and management protocol. Pak J Obstet Gynaecol. 1992; 5:23-5.
7. Juneja A, Sehgal A, Sharma S, Pandey A. Cervical cancer screening in India: Strategies revisited. Indian journal of medical sciences. 2007 Jan 1; 61(1):34.
8. Eddy DM. Screening for colorectal cancer. Annals of Internal Medicine. 1990 Sep 1; 113(5):373-84.
9. Celentano DD, DeLissovoy G. Assessment of cervical cancer screening and follow-up programs. Public health reviews. 1988 Dec; 17(2-3):173-240.
10. Khare A, Bansal R, Sharma S, Elhence P, Makkar N, Tyagi Y. Morphological Spectrum of Endometrium in Patients Presenting with Dysfunctional Uterine Bleeding. 2012; 5 (2): 1316.
11. Pajtler M, Audy-Jurković S. Pap Smear Adequacy– Is the Assessing Criterion Including Endocervical Cells Really Valid?. Collegium antropologicum. 2002 Dec 16; 26(2):565-70.
12. Senapathy JG, Umadevi P, Kannika PS. The present scenario of cervical cancer control and HPV epidemiology in India: an outline. Asian Pac J Cancer Prev. 2011 Jan 1;12(5):1107-5.
13. Ranabhat SK, Shrestha R, Tiwari M. Analysis of abnormal epithelial lesions in cervical Pap smears in Mid-Western Nepal. Journal of Pathology of Nepal. 2011; 1(1):30-3.
14. Altaf FJ. Cervical cancer screening with pattern of Pap smear. Review of multicenter studies. Saudi medical journal. 2006; 27(10):1498-502.
15. Patel MM, Pandya AN, Modi J. Cervical Pap smear study and its utility in cancer screening, to specify the strategy for cervical cancer control. National Journal of Community Medicine. 2011; 2(1):49-51.
16. Ghazal-Aswad S, Gargash H, Badrinath P, Al Sharhan MA, Sidky I, Osman N, Chan NH. Cervical smear abnormalities in the United Arab Emirates. Acta cytologica. 2006 Jul 1; 50(1):41-7.
17. Nikumbh DB, Nikumbh RD, Dombale VD, Jagtap SV, Desai SR. Cervicovaginal Cytology: Clinicopathological and Social Aspect of Cervical Cancer Screening in Rural (Maharashtra) India. Int J Health Sci Res. 2012; 1:125-32.
18. Balaha MH, Al Moghannum MS, Al Ghowinem N, Al Omran S. Cytological pattern of cervical Papanicolaou smear in eastern region of Saudi Arabia. Journal of Cytology. 2011 Oct 1; 28(4):173.
19. Vaidya A. Comparison of Pap test among high and non-high risk female. 2003; 1:8-13.

Dr Shailesh Kumar Pankaj

Tutor, Department of Pathology, NMCH, Patna, India