Cervical Smear Research Paper

Abstract
Introduction: Last few decades saw a Pap smear becoming synonymous with early detection of cervical carcinoma, leading to its rapid decline worldwide. However, newer screening modalities like liquid cytology have been embraced by the developed world. The relevance of the Pap smear in developing countries like India needs to be evaluated.
Objectives: To assess the risk factors associated with cervical carcinoma. To correlate cyto-clinical–histopathological findings in the unhealthy cervix by Pap smear to determine its validity and feasibility.
Materials and methods: Pap smears from 1,000 patients who presented in the Gynaecology department with the unhealthy cervix (discharge, bleeding or signs like erosion were clinically grouped

Risk factors for malignancy showed significant association with epithelial cell abnormality (P = 0.05%). Cervical smears showing epithelial cell abnormality were significantly associated with the clinical findings like discharge (P = 0.001), erosion (P-value = 0.002) and unhealthy looking cervix (P-value = 0.028). Pap smear showed 59.4% sensitivity, a positive predictive value of 95.4 and 55.9% concordance with the biopsy.
Conclusion: Pap smear has moderate sensitivity and high specificity. The feasibility and cost effectiveness of Pap smear to detect cervical cancer in the presence of significant risk factors and unhealthy symptoms makes it an effective screening procedure in the developing countries with limited resources and

INTRODUCTION The worldwide rate of cervical cancer has come down to two-fifth of what it was 50 years ago, mainly due to effective Pap smear screening1. However, 75% of the new cases are reported to occur in the developing countries, mainly due to ineffective screening programmes or lack of awareness. It is the most common neoplasm among Indian women and accounts for 20–50% of all cancers in India and 80–85% of female genital cancers in India2. India has significant socio-demographic risk factors and unhealthy clinical findings for cervical carcinoma. With modern methods of cervical screening like liquid cytology, the effectiveness of Pap smear, a screening modality of lower sensitivity, is now in question. The purpose of our study was to assess the effectiveness and feasibility of the Pap smear in detecting the early cases of cervical cancer and to determine the risk factors associated with cervical cancer in a low resource country like India.

MATERIALS AND METHODS This was a descriptive study carried out in the Departments of Pathology and Obstetric Gynaecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, during the period from December 2011 to June 2013. The study was carried out after getting an approval from the Institutional Human Ethics