Abstract
Currently, a comprehensive program for screening and early detection of cervical cancer does not exist in Iran. This study aimed to determine the prevalence of abnormal Papanicolaou (Pap) smears and some related factors among women living in Zanjan, Iran. This cross-sectional study was conducted in 2012 in Zanjan on 4274 married women aged 20-65 years. The study participants were selected through two-stage cluster sampling. After obtaining written consent, demographic and fertility questionnaires were completed. Samples from cervix were obtained through a standard method using the Rover Cervex- Brush. Evaluation and interpretation of the samples were reported using the Bethesda 2001 method. Data were statistically analyzed using chi-square and logistic regression models. Most inflammatory changes in the samples were mild (37.4%). Abnormal atypical changes in the epithelial cells were found in 4.04%. The highest percentage of abnormal changes in the epithelial cells was atypical squamous cells of undetermined significance (ASCUS) (1.9%). Abnormal results of Pap smear was significantly and independently associated with age, papillomavirus infection, and lack of awareness about Pap smear tests. Given the high prevalence of inflammatory and precancerous changes in this study, compared to other studies in Iran and other Muslim countries, and the effect of demographic variables and individual factors on abnormal results, increasing the awareness of women and their families regarding the risk factors for cervical cancer, preventive measures such as screening, and timely treatment seem necessary.
Highlights
Cervical cancer is the second most common cancer among women
Lack of regular screening increases the risk of developing the disease up to 2-6 times. (Aggarwal, 2014; McGraw and Ferrante, 2014) it is believed that infection with human papillomavirus (HPV) is the main cause of the onset, development, and progression of cervical cancer (Stanley, 2012) Other factors contributing to cervical cancer are intercourse at early ages, polygamy, smoking, 1School of Nursing and Midwifery, 2Department of Midwifery, School of Nursing and Midwifery, 4Department of Obstetrics and Gynecology, 5Department of Pathology, Zanjan University of Medical Sciences, 3Zajan Social Determinants of Health Research Center, Zanjan, Iran *For correspondence: ahmad@zums.ac.ir
Cervical cancer is one of the most common causes of death among women in developing countries. Early detection of this disease in the precancerous stage based on Pap smear test screening is utmost importance especially in Muslim country
Summary
Cervical cancer is the second most common cancer among women. It annually endangers the health of countless women around the world. In the past 50 years, a significant reduction has been observed in the incidence and mortality rate of cervical cancer in developed countries. In developing countries, this cancer is the second most common cancer in women and the leading cause of deaths due to cancer among them (Arbyn et al, 2011; Benard et al, 2014). This study aimed to determine the prevalence of abnormal Papanicolaou (Pap) smears and some related factors among women living in Zanjan, Iran. Conclusions: Given the high prevalence of inflammatory and precancerous changes in this study, compared to other studies in Iran and other Muslim countries, and the effect of demographic variables and individual factors on abnormal results, increasing the awareness of women and their families regarding the risk factors for cervical cancer, preventive measures such as screening, and timely treatment seem necessary
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