Abstract
Background:Inflammatory Pap smear is the most common report received by a gynecologist. The cervical screening algorithm for benign cellular changes on the Pap smear recommends treatment of infection if indicated and a repeat Pap smear in 4 to 6 months time. If the inflammatory changes still persist, subject the patient to colposcopy. However, in practice, this is not followed, especially in developing countries like ours where proper screening protocols are not available. Hence, a good number of patients in the premalignant stage are being missed. This study was undertaken to evaluate patients with persistent inflammatory Pap smears without atypia using colposcopy.Methods:A prospective analytical study of 150 gynecologial patients with persistent inflammatory Pap smear between 2006 and 2008 in an out-patient setting. All of them were subjected to colposcopy and biopsy from the abnormal areas. The incidence of cervical intraepithelial neoplasia (CIN)/invasive carcinoma was calculated by proportions/percentages.Results:The incidence of invasive carcinoma was <1%. But, the incidence of pre-malignant lesions (CIN) was high (20.9%). CIN 2/3 and carcinoma in situ were present in 6.9% of the cases.Conclusions:Patients with persistent inflammatory Pap smears can harbour a high proportion of CIN and hence these patients will need further evaluation.
Highlights
Cervical cancer is a cancer arising from the cervixes
Contact bleeding, or a vaginal mass may indicate the presence of malignancy
It is not practically feasible to subject all women with inflammatory pap smear to colposcopy in our country
Summary
Cervical cancer is a cancer arising from the cervixes. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Later symptoms may include abnormal vaginal bleeding, pelvic pain, or pain during sexual intercourse. Moderate pain during sexual intercourse and vaginal discharge are symptoms of cervical cancer. Metastases may be present in the abdomen, lungs, or elsewhere.Symptoms of advanced cervical cancer may include: loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, swollen legs, heavy vaginal bleeding, bone fractures, and (rarely) leakage of urine or feces from the vagina. Bleeding after douching or after a pelvic exam is a common symptom of cervical cancer.[2]. Inflammatory Pap smear is the most common colposcopic evaluation of cervix with persistent Inflammation Pap smear. Colposcopic Evaluation of Cervix with Persistent Inflammatory Pap Smear incendiary changes proceed with, the patient is to be subjected to colposcopy. It is not practically feasible to subject all women with inflammatory pap smear to colposcopy in our country
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