Abstract
Background: Incidence of cervical cancer has decreased in the developed world due to use of Pap smear as a screening tool. It has been proven as a sensitive screening tool for cervical cancer but its coverage is very low in Nepal. The objective of this study is to find out the incidence of cervical epithelial cell abnormality, its demographic distribution and common presenting symptoms.
 Materials and Methods: This retrospective comparative study was conducted in Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. A total of 950 patients attending gynecological department with various symptoms were enrolled. Only 902 patients were included in the study after excluding inadequate samples.
 Results: The mean age of patient was 37.94 ± 12.74 years with minimum age of 18 and maximum age of 79 years. The mean age of patients with epithelial abnormality was 47.88 ± 8.87 years. The highest number of Atypical squamous cells of undetermined significance was observed between 51-60 years (1.1%) whereas Low and High grade squamous intraepithelial lesion were mostly observed between 41-50 years (3.2% and 0.4% respectively). The most common symptom was vaginal discharge (41.6%) followed by pain abdomen (23.1%).
 Conclusions: Pap smear is a cost effective, sensitive and simple screening test for cervical premalignant and malignant lesions.
Highlights
Cervical cancer is the fourth most common cancer amongst women worldwide and second to breast cancer in developing countries and was responsible for 569,847 new cases and 311,365 deaths in 2018 worldwide.[1]
The highest number of ASCUS was observed in women between 51-60 years (1.1%) whereas LSIL and HSIL were mostly observed in women between 41-50 years (3.2% and 0.4% respectively)
Populationbased study done in Bharatpur, Nepal by Sherpa AT et al found ASCUS in 2.8%, LSIL in 0.2% and HSIL in 0.5% patients which is lower as compared to our hospital based study.[10]
Summary
Cervical cancer is the fourth most common cancer amongst women worldwide and second to breast cancer in developing countries and was responsible for 569,847 new cases and 311,365 deaths in 2018 worldwide.[1]. Cervical Pap smear is a sensitive test for early screening of cervical lesions and is the most widely used system.[6] It is stated that the annual incidence and prevalence of cervical cancer has decreased by 50-70% after the introduction of population-based screening.[7] So, if women undergo screening for cervical cancer, it can be detected in early stages thereby reducing the mortality and morbidity. Incidence of cervical cancer has decreased in the developed world due to use of Pap smear as a screening tool. It has been proven as a sensitive screening tool for cervical cancer but its coverage is very low in Nepal. The objective of this study is to find out the incidence of cervical epithelial cell abnormality, its demographic distribution and common presenting symptoms
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