Abstract

Objective: Carcinoma cervix is the most common carcinoma of female. India is said to be the capital of cancer cervix because of highest incidence rate and mortality rate. It is more prevalent in rural area. In urban area its incidence is somewhat lower where carcinoma breast is emerging as most common cancer in female. The aim of present study was to determine the prevalence of Carcinoma cervix and role of pap smear with revised Bethesda system of reporting as a screening test.

Materials and Method: A total of 78 female patients, of different age groups, presents with various genital complains, attending in obstetrics and gynecology out patients door were included in the study. All the demographic data were noted. From all the patient pap smear were taken and send for cytological evaluation in pathology department. All the fixed smears were stained by papanicolaou stain and seen under oil immersion lens.

Result: Out of 78 patients, 66.67% patients were in 51-60 years of age, 60.26% women were comes from Hindu community. 55.13% patients had low socioeconomic status, multiparity was seen in (62.82%) of cases and 65.38% had rural based origin. Majority of patients, 71.79%  had lower abdominal pain , followed by chronic backache in 66.67%, vaginal discharge in 41.02% and 30.76% had Irregular vaginal bleeding. In cytological finding maximum patients (41.02%) were found to have Negative for intraepithelial malignancy (NILM), Atypical squamous cell of undetermined significance (ASCUS) was seen in 33.34% of cases, 15.38% patients had Low grade squamous intraepithelial lesion (LSIL), 7.70% patients showed High grade squamous intraepithelial lesion (HSIL) and 2.56% patients were diagnosed as squamous cell carcinoma. Bacterial vaginosis was the most common infection found in 30.76% of patients followed by fungal (Candida albicans) in 8.98%, Trichomonas in 6.42% of patients and mixed infection in 10.26% of cases. Maximum number of patients had only mild dysplastic charges and were seen in 45-55 year of age groups. In correlation of parity with dysplasia, ASCUS was most common in 1-3 children group, LSIL was most common in 4-5 children group and HSIL was noticed mostly in 4-5 children group.

Conclusion: pap smear is a rapid, cost effective and outpatient department procedure which is capable of detecting neoplastic as well as non-neoplastic cervical lesions at the earliest and if applied judiciously to all women it will lead to a fall in incidence and mortality of cervical cancer. Since prevention is always better than cure, we should stress more on education, prevention and treatment of sexually transmitted diseases, family planning measures, widespread use of cytological screening, referral system for patients with dysplasia's to the good more thoroughly equipped centers and of course, utilization of all possible resources for proper management and follow up of these cases. It will decrease the morbidity as well as mortality associated with invasive cancer of cervix.

Keywords: Pap smear, screening test, Bethesda system of reporting, LSIL, HSIL, Ca Cervix.