Cytohistological correlation and accuracy of the pap smear test in diagnosis of cervical lesions: a hospital based cross-sectional study from Odisha, India

Abstract

Background

Cervical carcinoma is one of the most common causes of mortality among women. Early detection can be done by Papanicolaou (Pap) smear test - a simplest, safe, cost effective and non invasive procedure. The main objective of this study was to categorize Pap smears for cytohistological examination as well as clinically correlate to analyze sensitivity, specificity and positive predictive value of Pap smear. 

Methods

In this prospective study 417 Pap smears performed, cytohistological correlation was done in 104 cases because patients had undergone both Pap smear and cervical biopsy. Detailed history was taken and clinical examination was done. Pap smear sample was collected from cervix and reporting was made according to Bethesda 2001 classification. Cytological findings were correlated with histopathology. 

Results

Overall concordance rate was 60.7%. Concordance rate for malignancy was 100%, for inflammatory lesions 70.8% and for cervical intraepithelial neoplasia (CIN) 33.3%. Common age group presented for screening was40-50 years. Commonest clinical presentation was bleeding per vaginum.

Conclusion

The study provides good cyto-histopathology correlation in detecting high grade lesions and malignancy. Although Pap smear sensitivity was low but can be increased by adequate sampling and avoiding technical errors. Bethesda system is strongly recommended for adequacy of sampling to minimize inconsistency. Regular screening should be advised to the patients for the early detection of cervical carcinoma.