Prevalence of infectious organisms observed in cervical smears between 1997-2014 at mubarak al kabeer hospital, kuwait

Objectives: This study aimed to examine gynaecological infectious agents observed in conventional and modified Papanicolaou cervical smears [CS] at a tertiary care hospital in Kuwait

Methods: This retrospective study analysed 121,443 satisfactory CS samples collected between 1997–2014 at the Mubarak Al-Kabeer Hospital, Kuwait. Conventional CS samples were obtained between 1997-2005, while modified CS were obtained between 2006-2014 following the introduction of ThinPrep testing [Hologic Corp., Bedford, Massachusetts, USA]. All samples were initially screened by cytoscreeners before being analysed by cytopathologists to determine the presence of specific infectious agents

Results: Overall, 8,836 [7.28%] of the cervical samples had infectious agents; of these, 62.48% were conventional and 37.52% were modified CS samples. The most frequently observed infectious agents were Candida species [76.05%], Trichomonas vaginalis [9.72%], human papillomavirus [HPV; 9.3%], Actinomyces-like organisms [3.23%], Chlamydia trachomatis [1.27%] and the herpes simplex virus [HSV; 0.43%]. There were significantly more cases of Candida species, HPV-associated changes, C. trachomatis, T. vaginalis and Actinomyces-like organisms detected in conventional compared to modified CS samples [P <0.050 each]. However, there was no statistically significant difference in the frequency of HSV-associated changes [P = 0.938]. The presence of two infectious agents in the same sample was identified in 0.87% of samples

Conclusion: Among CS samples collected during an 18-year period, Candida species were most frequently detected, followed by T. vaginalis and HPV. The identification of potential infectious agents is a valuable additional benefit of Papanicolaou smear testing

Trends in epithelial cell abnormalities observed on cervical smears over a 21-year period in a tertiary care hospital in Kuwait

This study aimed to analyse trends in epithelial cell abnormalities [ECAs] in cervical cytology at a tertiary care hospital in Kuwait. ECAs in 135,766 reports were compared over three seven-year periods between 1992 and 2012. Conventional Papanicolaou [Pap] smear tests were used in the first two periods and ThinPrep [Hologic Corp., Bedford, Massachusetts, USA] tests were used in the third. Significant increases in satisfactory smears, atypical squamous cells of undetermined significance [ASCUS] and atypical glandular cells of undetermined significance/atypical glandular cells [AGUS/AGCs] were seen in the second and third periods [P <0.001]. No significant increases were observed among low-grade squamous intraepithelial lesions [LSILs] or high-grade squamous intraepithelial lesions [HSILs] [P >0.05]. An increase was noted in carcinomas between the first and second periods although a significant decline was seen in the third [P <0.014]. Satisfactory smears, ASCUS and AGUS/AGC increased during the study period although no significant increases in LSILs, HSILs or carcinomas were observed

Changing spectrum of squamous cell abnormalities observed on papanicolaou smears in Mubarak Al-Kabeer Hospital, Kuwait, over a 13-year period

The aim of this study was to determine the incidence of squamous cell abnormalities in cervical cytology in Mubarak Al-Kabeer Hospital, Kuwait, and to document any change in the pattern of these lesions. Over a 13-year period [1992-2004], 86,434 cervical smears were studied in Mubarak Al-Kabeer Hospital, Kuwait. Conventional Pap smears were first examined by cytotechnicians and finally reported by cytopathologists. The smears were classified according to the modified Bethesda system. The age of presentation of squamous cell abnormalities in Kuwaiti women was analyzed. Smears from 83,052 [96.09%] patients were found satisfactory for reporting while the remaining 3.9% was unsatisfactory. Atypical squamous cells of undetermined significance [ASCUS] were seen in 1,790 [2.2%] cases, atypical glandular cells of undetermined significance [AGUS] in 630 [0.8%] cases, low grade squamous intraepithelial lesion including human papillomavirus changes [LSIL] in 824 [1.0%] cases, high grade squamous intraepithelial lesion [HSIL] in 189 [0.2%] cases, and carcinoma in 79 [0.1%] cases of which 44 [0.05%] were squamous cell carcinoma. A comparison of average cases/annum during the study period revealed a significant increase in ASCUS from 1.13 to 2.83% [p < 0.001] and AGUS from 0.33 to 1.08% [p < 0.001]. However, the percentage of LSIL, HSIL and carcinoma detected in Pap smears remained the same. A significant linear trend [p < 0.001] was observed in satisfactory smears, ASCUS and AGUS over the years. However, no significant change was found in the detection of LSIL, HSIL and carcinoma. A reduction in the age of LSIL/HSIL and an increasing trend in the number of Kuwaiti women over the years was also observed which makes screening of young women essential in Kuwait