Clinicopathological significance of Papanicolaou smear study in Postmenopausal women
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Introduction: Cervical cancer is the most common cancer worldwide and a major fatal malignancy among women, mostly in developing countries. Human papilloma virus(HPV), a sexually transmitted oncogenic virus, plays a major role in the development of cervical cancer(1). Cervical cancer is readily preventable when effective programmes are conducted to detect and treat its precursor lesions(2). Pap smear is a simple, safe, non invasive, economical and effective method for detection of precancerous, cancerous and other lesions of the cervix(3). In India the peak age for cervical cancer is 55-59yrs. Elderly women are more likely to be diagnosed at a late stage due to lack of regular access to gynaecological care or cancer screening(4). Mortality rate is higher in countries where screening and appropriate treatment facilities are not available(1) . The aim of the present study is to determine the significance of cervical pap smear in postmenopausal women. Aims and objectives: 1. To determine the prevalance of various cervical lesions in post menopausal women. 2. To study the distribution of cervical cancer among post menopausal women. 3. To assess the significance of screening in postmenopausal women Material and methods: A prospective study was conducted in Department of Pathology of a tertiary care hospital from July 2016 to June 2018 after obtaining informed consent. A total of 520 smears were studied. Detailed clinical data is obtained from patients record. The prefixed conventional smears received from Department of Gynaecology were stained with Pap stain and studied. The cytosmears were reported using the cervical Bethesda system terminology. Inclusion criteria: Postmenopausal women who attended Gynaecology clinic -with complaints of white discharge, postmenopausal bleeding, pain abdomen etc. -For routine screening Exclusion criteria: Inadequate or Unsatisfactory smears Women who had not giving consent Results: Among 520 smears examined during the study period, most of the women presented with complaints of bleeding PV (27.11%), followed by prolapse(22.11%). NILM accounted for the majority of case(87.66%) and LSIL was the most common epithelial cell abnormality(4.80%) in our study. Highest number of epithelial cell abnormalities (27.11%) were seen in women with bleeding PV. Conclusion: The most common presenting symptom in postmenopausal women is bleeding PV. NILM was the most common cytodiagnosis. Of the epithelial cell abnormalities, LSIL was the most common followed by HSIL and SCC. SCC was diagnosed on Pap smear in 1.03% of asymptomatic women.
Authors and Affiliations
Dr. A. Madhuri, Dr. B. Anuradha, Dr. N. V. H. Rajesh krishna
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