Abstract
BACKGROUND: Cervical cancer is the most common type of cancer affecting the genital tract among women in developing countries. Screening programmes have been well talked about in Nigeria, but they are not well organized. Hence, the incidence of cervical cancer does not appear to be reducing. A possible way of solving this problem is by doing an opportunistic pap smear among women attending antenatal clinics, since a good number of women do access antenatal care. OBJECTIVES: To determine the prevalence, knowledge, awareness, practice, risk factors and pattern of Pap smear among women attending antenatal clinic in Mile 4 hospital, Abakaliki. METHOD: This is a cross-sectional study carried out at the antenatal clinic of Mile 4 Hospital, Abakaliki, Nigeria. A total of 110 consecutive pregnant women who fulfilled the inclusion criteria and have given their consent were recruited into the study at the time of their first prenatal (booking clinic) visit for antenatal care. Data was collected using a questionnaire. Conventional Papanicolaou smear was taken using the standard procedure. The cytopathologic findings were documented in the questionnaire. RESULTS: Out of the 110 pregnant women who had cervical cytology by Pap smear, 7 had pre-invasive cervical lesion, giving a prevalence rate of 6.3%; 5 (71.4%) were low-grade squamous intraepithelial lesion (LGSIL) while 2 (28.6%) were high-grade squamous intraepithelial lesion (HGSIL). Fifty women (45.5%) had negative smears. Inflammatory smears were seen in 50 women (45.5%). Insufficient smear was seen in 3 women (2.7%). Fifty-six women had knowledge about cervical cancer (50.9%), while thirty-six women (32.7%) were aware of a screening program for cervical cancer and only 2 women (1.8%) had been screened in the past. Hence, from this study, the population screening rate was approximately 2%. The risk factors were age of coitarche <15 years, number of sexual partners, previous history of sexual transmitted infection, genital warts, human immune deficiency virus and use of contraceptives. CONCLUSION: The pap-smear findings among pregnant women in Abakaliki, Nigeria showed that the pre-invasive lesion of the cervix is relatively common. Pap smear should be made routine for all pregnant women.
Highlights
Cervical cancer is the most common type of cancer affecting the genital tract among women in developing countries and Nigeria is not an exception
Out of the 110 pregnant women who had cervical cytology by Pap smear, 7 had pre-invasive cervical lesion, giving a prevalence rate of 6.3%; 5 (71.4%) were low-grade squamous intraepithelial lesion (LGSIL) while 2 (28.6%) were high-grade squamous intraepithelial lesion (HGSIL)
The pap-smear findings among pregnant women in Abakaliki, Nigeria showed that the pre-invasive lesion of the cervix is relatively common
Summary
Cervical cancer is the most common type of cancer affecting the genital tract among women in developing countries and Nigeria is not an exception. At least 1% of the population of childbearing women screened annually for cervical cancer will be diagnosed with CIN [4] Since these precursor lesions can be detected by screening and are amenable to treatment before it becomes invasive, pregnancy offers an excellent opportunity for screening. In the United States, about 2 - 3 million abnormal Pap smears are diagnosed each year and 5% - 13% of these are detected in pregnant women [4] It poses an opportunity for us to provide cervical cancer screening that should not be missed. Several risk factors have been associated with cervical intraepithelial neoplasia (CIN) and subsequent development of an invasive disease These risk factors are known to be associated with HPV infection [5]. This study aimed to determine the prevalence and pattern of pre-invasive cervical lesion in pregnancy
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