Cytologic and colposcopic evaluation of all symptomatic women at tertiary care centre

Abstract

Background: Cervical cancer in India ranks as the 2nd most frequent cancer among women and the 2nd most frequent cancer among women between 15 and 44 years of age. Invasive carcinoma of cervix is preventable as it is associated with pre-invasive stage which occurs 10-15 years prior to it, thus permitting early detection by screening and leading to effective treatment and thereby reducing mortality rate with greater impact on lives saved. Objectives were to correlate the findings of Pap smear with colposcopy in evaluation of all symptomatic women; and to assess the utility of colposcopy in detecting the premalignant and malignant lesions of cervix.Methods: This was a prospective observational study of 200 symptomatic women attending the Gynecology OPD of Umaid Hospital Dr. S. N. Medical College Jodhpur, Rajasthan, India from February 2015 to October 2016. Evaluation of all symptomatic women done with Pap smear, colposcopy and biopsy in selected cases and findings were noted.Results: Commonest complaint was white discharge per vaginum in 58.5% followed by pelvic pain in 24% women. 8% women had abnormal pap smear findings with 4% of women had ASCUS, 0.5% had ASC-H, 3% had LSIL and 0.5% had HSIL,73% had inflammatory and 19% with normal smear. 38.5% had abnormal colposcopy with maximum 28% women had acetowhite lesions. Sensitivity of pap smear was 44.44% while sensitivity of colposcopy was 88.88%.Conclusions: Pap smear had poor sensitivity as compared to colposcopy. Hence simultaneous use of colposcopy has shown to increase in the rate of carcinoma cervix detection in symptomatic women.