Cytopathological pattern of cervical pap smears - a study among population of North Malabar in Kerala

• Author Details:   
• Geethu G. Nair
• Fatima Shamsuddin
• Thidil Narayanan
• Prejisha Balan

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Background: India, the second most populous country in the world accounts for about 25% of cervical cancer deaths. Only limited studies are available on the prevalence of cervical epithelial abnormalities in various populations in India, especially in North Kerala. We have undertaken the present study, with the intention to estimate the prevalence of abnormal cervical cytology smears in this region so that appropriate screening strategies can be planned.
Methods & Materials: A one year retrospective descriptive study was conducted in Department of Pathology of a private medical college to evaluate all the pap smears reported during September 2012 to August, 2013. Smears were assessed according to the revised 2001 Bethesda system. A total of 2028 cases were analyzed. Prevalence of epithelial abnormalities was calculated in percentages.
Results: Out of total 2028 patients, 49 (2.41%) cases revealed epithelial abnormalities. The most frequent epithelial cell abnormality was Low grade Squamous Intra epithelial Lesion (32 cases, 1.58%). Nearly half of the patients with abnormal pap smears presented with a normal looking cervix. Epithelial abnormality was more prevalent in post-menopausal age group.
Conclusion: Our hospital based study shows a relatively low prevalence of cervical epithelial abnormality which is similar to that seen in the developed world. Every woman above the age of 30 must be subjected to Pap smear even with a normal looking cervix and this must be continued in post-menopausal period, as most of patients with epithelial abnormalities in our study falls in this group.

Keywords: Epithelial Abnormality; North Kerala; Pap smear; Prevalence