Cervical cancer screening program: Review of literature

Objectives: The objective of the study is to evaluate the results of cervical cancer screening and human papillomavirus (HPV) testing, with a review of the HPV vaccination program and to identify cytological patterns based on the 2014 Bethesda System and HPV status in Bahraini women across different age groups from 2020 to 2023. Materials and Methods: This retrospective study analyzed the results of all cervical cytology smears and HPV status in Bahrain from 2020 to 2023 using the 2014 Bethesda System for Reporting Cervical Cytology. Results: Of the 24,159 cervical papanicolaou (PAP) smears studied, 22,218 (92%) were negative for intraepithelial lesion or malignancy (NILM), and 1941 (8%) were abnormal; high-risk HPV (hrHPV) test was performed on 789 cases. Among these, 8.7% were NILM, 52.1% were atypical squamous cells of undetermined significance or high-grade lesions cannot be excluded (ASCUS/ASCH), and 3.2% were malignant. Abnormal findings were higher in the 40–49 years age group. HPV 16 was detected in 9.8% of cases, HPV 18–45 in 3.8% of cases, and other high-risk HPV (hrHPV) in 20.8% of cases, while 79.2% tested negative. HPV 16, 18–45, and other hrHPV types were prevalent in the 30–49-year age group. Conclusion: The highest prevalence of abnormal findings was in the ASCUS/ASCH category, particularly in younger women, suggesting the need for careful monitoring to prevent progression to higher-grade lesions. The findings align with global patterns, where hrHPV peaks in younger women and declines with age, indicating the importance of age-specific screening. The presence of HPV 16 and other high-risk types in women aged 30–49 highlights the importance of HPV vaccination and regular screening.