A comparative study of Pap smear and colposcopy guided biopsy in the evaluation of unhealthy cervix

ABSTRACT

Background: Cancer of cervix ranks as the third common malignancy in females worldwide. In developing countries like India, carcinoma cervix is the second commonest malignancy affecting females. In India, every year 1,26,000 new cases are identified and 67,477 deaths occur due to cervical carcinoma. Cervical carcinoma affects women of age 15-44 years and disease peaks at 55-66 years. On average, Indian women have a 2.5% risk of developing carcinoma cervix. It was estimated worldwide that every 5th woman, who suffer from cervical cancer belongs to India.Methods: A comparative study which included 110 married women of age 20 to 65 years. Women who presented with white discharge, lower abdominal pain, post coital bleeding and post-menopausal bleeding were subjected to Pap smear and colposcopy guided biopsy.Results: A total 53.6% women had inflammatory smear, followed by 34.5% women with normal Pap smear, 0.1% women had bacterial vaginosis, 6.4% women had LSIL and 4.5% women had HSIL. Authors found that 63.6% women had chronic cervicitis. 15.4% had chronic endo papillary cervicitis, 13.6% had CIN 1, 5.4% women had CIN 2 and 1.8% women had squamous cell carcinoma. Association of Pap smear with histopathology is statistically significant (p value <0.001).Conclusions: Pap smear can be used as screening test for detecting premalignant lesions of cervix. Colposcopy guided cervix biopsy has got better specificity than Pap smear, so all symptomatic women should be subjected to colposcopy guided cervix biopsy to detect carcinoma at early stage.