Detection of Abnormal Cervical Epithelial Lesions by Papanicolaou Smear: A Retrospective Study

Abstract Introduction: A substantial portion of both mortality and morbidity is attributed to cervical cancer, which is the second most frequent malignancy in women. Papanicolaou (PAP) smear is a simple, cost-effective, and sensitive test for detecting cervical lesions. The purpose of the study was to determine the pattern of different cervical smear abnormalities and the prevalence of epithelial cell abnormalities in the study group. Materials and Methods: This was a retrospective study of 1780 cervical PAP smears screened and reported at Nagpur, India, from January 2022 to December 2022. The traditional approach was used for performing PAP smears and the reporting followed the guidelines of the Bethesda system. Special attention was given to abnormalities in epithelial cells. Results: The majority of the women were multiparous and between the ages of 30 and 50. Among women, the most prevalent complaint was vaginal discharge, with 658 (36.96%) reporting it, 456 (25.6%) reported abdominal pain, 230 (12.9%) women had an irregular menstrual cycle, and 270 (15.16%) were asymptomatic. An adequate PAP smear was obtained from 1665 (93.53%) of the women, whereas 114 (6.4%) had an unsatisfactory sample, negative for intraepithelial lesion or malignancy was found in 869 (48.8%) of the women and 760 (42.6%) revealed infection. Detection rates for low-grade squamous intraepithelial lesions (LSIL), atypical squamous cells of undetermined significance (ASCUS), and high-grade squamous intraepithelial lesions (HSIL) were 90 (5.05%), 51 (2.86%), and 10 (0.56%), respectively. Females who were diagnosed with ASCUS, LSIL, or HSIL in their PAP smears had a colposcopy and a guided biopsy. Conclusions: PAP smears are exceptionally effective tools for identifying precancerous cervical lesions due to their high sensitivity, specificity, and efficiency, minimizing treatment burden, mortality, and morbidity. Considering the number of women who have not previously undergone a PAP smear, it is necessary to educate the community about the purpose and recommended frequency of PAP smear testing through widespread educational efforts and media initiatives.