Utility of Pap Smear Screening for Prevention of Cervical Cancer-A 3yrs Study from Rural Tripura-A Northeastern State of India

Abstract

Background: Cancer cervix is a leading cause of mortality and morbidity among women worldwide. According to National Cancer Registry Program of India, cancers of cervix and breast are leading malignancies in Indian women. The morbidity and mortality could be significantly reduced with an active cervical smear screening programme. Objective: The study was done to evaluate the knowledge and attitudes of women about cervical smear testing, to establish a cervical smear screening program and to evaluate the cervical cytological abnormalities. It was done to determine the applicability, limitations and utility of this screening in a district hospital. Materials and Methods: A total of 287 married women were included in our study. Knowledge about Pap smear testing was determined through printed questionnaires. Pap smear screening was performed on every woman in our study group. Detailed clinical data and cytology reports were noted in a proforma. Results: About 92% women of our study group had never heard or undergone Pap smear screening before. Maximum number of patients was in 4th decade. Of the 287 smears, 276(96.16%) were adequate. Normal smear were 78(27.18%), inflammatory 168(58.54%), whereas epithelial cell abnormalities were seen in 26(9.05%) cases. The 26 abnormal cases comprised of 17(5.92%) cases with ASCUS, 5(1.74%) cases of LSIL, 1(0.35%) cases of HSIL, 3(1.04%) cases of squamous cell carcinoma. Conclusions: Epithelial cell abnormality in our study group was less than Western countries. There is poor knowledge about Pap smear screening. Pap smear study can be easily done through a chain built between the primary health care unit and district hospital and laboratory.