The Cervical pap smear cytological changes with clinicopathological correlation in a sample of Iraqi patients

Objectives: This study aimed to evaluate the role of Pap test in detecting pre-cancerous lesions in Iraqi women aged 45 years to 85 years, correlate the pap result with patient’s age, parity, number of births, number of abortions, chief complaint, and clinical cervical exam, and to evaluate the diagnostic accuracy of the pap test in correlation to histopathological examination. Methods: Women who attended the outpatient gynaecological clinic of the Department of Obstetrics and Gynaecology at Baghdad medical city, Baghdad, Iraq, from January 2019 to January 2020 who had different chief complaints were selected for the study. Women who are 45 years to 85 years old were included in the study. A Pap smear was used for all women to screen for cervical cancer and the results were reported according to the 2014 Bethesda system. The data analysis was done utilizing statistical package for social sciences version 24 (SPSS v24). Results: Total number of pap smears analyzed were 510, NILM (negative for intraepithelial lesions or malignancy) constituted major group 464/510 (91%) and epithelial cell abnormality were 46/510 (9%), age is significantly correlated with increasing rate of pre-neoplastic and neoplastic lesions in women and the significance of vaginal discharge & postmenopausal bleeding and its association with premalignant changes in the cervix. The sensitivity of Pap test is 94%, the Specificity was 60% and accuracy rate 74%. Conclusion: There is significant correlation between Pap smear abnormality and increasing age, vaginal discharge and postmenopausal bleeding, were evident in this study.