A CROSS-SECTIONAL OBSERVATIONAL STUDY FOR SCREENING OF CERVICAL CANCER BY PAP SMEAR AMONG ALL ANTENATAL WOMAN ATTENDING THE CLINIC AT TERTIARY CARE CENTER IN RURAL AREA

Background: Cervical cancer is one of the most prevalent gynaecological malignancies among Indian women and a leading cause of cancerrelated mortality in low-resource settings. The Pap smear is a simple and cost-effective screening tool for detecting cervical abnormalities. Pregnancy presents a unique opportunity for screening, as most women seek medical attention during this period. This study was undertaken to screen for cervical cancer by Pap smear among antenatal women attending a rural tertiary care centre. Patients were Material and Methods: included in the study groups based on the inclusion criteria of the study. The purpose of the study was conveyed to all patients and an Informed consent form were collected from all participants. Cervical cancer screening questionnaire was asked of each participant. Demographic data such as name, age, etc was collected. Obstetric history and present data was collected. Laboratory investigations including random blood sugar (RBS), coagulation prole, complete blood count (CBC), and Thyroid etc results was collected. History of drug uses were assessed in detail. The study was conducted on all antenatal patients visiting our Antenatal clinic willing for the screening at krishna mohan medical college and hospital, Pali dungra sonkh road, Mathura. Women ready to participate in the study was enrolled and Informed consent form was collected from all patients enrolled for the study. The patient was positioned for a lithotomy. A Cusco's speculum was inserted into the vagina to view the cervix. Ayre's spatula will be used to gather the smear. All smears were applied a xative right away and delivered to the pathology department. The cytological abnormalities were reported as per modied Bethesda classication (2014). Atypical squamous/glandular cells (or more of them), and atypical squamous cells of undetermined signicance (ASC-US), atypical squamous cells that cannot exclude high-grade squamous intraepithelial lesions (HSIL), lowgrade squamous intraepithelial lesions (LSIL), atypical glandular cells not otherwise specied (AGC-NOS) was considered as abnormal results. The results was statistically analyzed. P value less than 0.05 will be considered signicant. Out of 120 Results: antenatal women screened, 50.83% had abnormal Pap smear ndings. Inammatory changes were the most common (43.33%), followed by LSIL (5%), ASC-US (1.67%), and HSIL (0.83%). The mean age was 27.3 years. Multigravida status was seen in 55.83% of patients. A statistically signicant association was observed between Pap smear abnormalities and parity (p = 0.001), socioeconomic status (p = 0.003), and gross cervical appearance (p = 0.003). No signicant association was found with age or gestational age. Pregnancy is the period during which Conclusion: a woman denitely seeks medical care and antenatal clinics provide opportunities for screening. The antenatal period is when majority of women will have the opportunity to contact a health care worker irrespective of their educational status. It thus becomes imperative that this opportunity is not lost. Routine screening for cervical cancers in India although being carried out lacks a national policy or framework unlike western countries where women are routinely invited for testing and diligent records are kept. Clinicians should make every effort to educate, counsel and screen pregnant women if they have not had a Pap test in the past. A robust screening system is thus the need of the hour