The level of inadequate Pap smears collected by the Gynecology Service of Fier Regional Hospital in Albania

Abstract

This study aimed to determine the level of smears inadequate for Pap test in a population of women in Fier Prefecture in Albania. Material and methods: This is a cross-sectional study including 1254 women who showed up for a Pap test at the gynecology service at the Fier Regional Hospital during 2013 and 2014. The women presented to our service either on their own initiative to perform the Pap test or recommended by the family doctor for this examination. Standard criteria were applied to classify a cervical smear as inadequate for interpretation. Reasons for the inadequate taking of Pap smears are discussed. Results: A total of 234 patients (96.2% females) were included. The average age of women in our study was 39.8 years ± 10.7 (34.2% were 31-40 years old and 27.1% were 41-50 years old). Overall, 9.6% of the cervical smears they were taken inadequately (there was a need to repeat the obtaining of the smear). Almost all materials were obtained from the exocervix and endocervix (in 98.1% of cases for which there is information on this variable). The absence of endocervical cells was the most frequent reason for classifying a smear as unsuitable for interpretation. Insufficient equipment, scarce material for cytological analysis and poor technical preparation can lead to the non-detection of abnormalities and errors in the microscopic analysis of smears. Conclusions: Each member of the team is responsible for the accuracy of the results, but also for the adequacy of the sample. Inadequate smears could lead to the need for repeat tests and increased health care costs. Regular internal control, work quality monitoring as well as continuous training of all experts involved in obtaining, storing and interpreting cervical smears could reduce the level of inadequate Pap smears. Keywords: Albania, adequacy, cervical cancer, cervical smear, Pap test.