Incidence and risk factors of abnormal cervical cytology in a university hospital - Saudi Arabia

Abstract

Background: Cervical cancer is the sixth on the list of the most widespread cancers in Saudi Arabia. It is a preventable disease. Identifying risk factors may suggest prevention strategies. Aims: Study aimed to determine incidence of abnormal cervical cytology for the period (2004-2013) and identify its risk factors. Settings: Study was conducted in the university hospital in Khobar. Design: Study was case- control, hospital- based. Materials and Methods: Cases were Saudis with 'abnormal Pap smear' and controls were healthy Saudis. Independent variables (socio-demographic and obstetrics and gynaecology history) were collected from patients' charts and hospital database. Incidence of abnormal cervical cytology was calculated using hospital statistics. Binary logistic regression was used to model predictors of abnormal cervical cytology. Odds ratio and 95% confidence interval (CI) were calculated. Five percent (%) level of significance was used. Stepwise logistic regression was applied to identify predictors of abnormal cervical cytology. Results: Incidence of abnormal cervical cytology in Saudi Arabia was low in comparison to other countries. Findings showed that 1.8% (129 cases during the period 2004-2013) of all women screened with Pap smear had abnormal cervical cytology and 2.5% (75 cases during the period 2004-2013) of Saudi women had abnormal Pap smear results. Risk factors associated with abnormal cervical cytology were use of intrauterine device (OR 2.851, P = 0.012) and repeated pregnancies (three or more, OR 3.116, P = 0.010). However, patients of age 30 to less than 50, patients conducted Pap smear once or more, and patients with partners using condom were protective factors. Conclusions: Early Pap smear screening should be activated for prevention of cervical cancer.