Citation Information :
Agrawal S, Agrawal M, Singh N, Agrawal P, Agrawal A. Efficacy of Hospital-based Cervical Cytology Screening: A 5-year Audit in a Tertiary Care Clinical Center. J South Asian Feder Obs Gynae 2022; 14 (5):545-550.
Introduction: India shares the huge burden of cervical cancer cases, contributing to nearly one-fourth of cervical cancer deaths worldwide. In wake of World Health Organization (WHO) global strategy to eliminate cervical cancer by 2030, there is a need to shift from opportunistic to population-based screening. Still, with limited resources, it is not feasible in current times. With this in mind, we performed wider hospital-based screening of females presenting to the outpatient department (OPD) of Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India and present its findings. We also studied the spectrum and prevalence of epithelial cell abnormality and its association with clinical parameters such as age, parity, socioeconomic status, and clinical findings.
Methods: Sexually active women in the age range of 21–65 years attending OPD for various complaints were screened from January 2015 to December 2019. Cervical cytology reports were retrieved from the hospital records. Demographic details of the patient along with presenting complaints were noted. Data was statistically analyzed using a statistical package for social sciences (SPSS software, version 20.0). The Student's t-test was used for comparison of continuous variables and the Chi-squared test for proportions.
Results: A total of 14,510 women were screened; the majority were multiparous, aged 30–50 years. A total of 38.4% of patients presented with a chief complaint of discharge per vaginum, 14.6% with menstrual disturbances, 19% with pain in the abdomen, and 22% with no complaints. There were 0.13% inadequate smears and 8.8% had an inflammatory smear, 4.6% cases showed reactive cellular changes, 5.5% low-grade squamous intraepithelial lesion (LSIL), 1.2% high-grade intraepithelial lesion (HSIL), 1.2% atypical squamous cell of unknown significance (ASCUS), 3.14% atypical squamous cells–cannot exclude HSIL (ASC-H) were of 0.19% and 0.01% (two cases), which were reported as squamous cell carcinoma (SCC). There was a significant correlation between the age of presentation, parity, socioeconomic status, and the presence of epithelial cell abnormality.
Conclusions: Cervical cytology is an effective method to screen for precancerous lesions of the cervix, with a wider hospital-based screening of a considerable number of females with cervical abnormalities that may be picked up for early intervention.
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