The spectrum of cytologic patterns in cervical smears of a high-risk group: Retrospective analysis of a cancer detection camp experience

Abstract

Background: Cervical cancer is a major public health concern, especially among women in developing countries like India. The human papillomavirus (HPV) is a widely recognized etiological factor for cervical carcinogenesis. There is an increased risk of the development of cervical cancer among certain groups of women, particularly the sex workers due to high HPV exposure. Objectives: This study was conducted to analyze the spectrum of epithelial cell abnormalities and the cytomorphology in the cervical smears of the high-risk groups of women in the North Malabar region of Kerala, India. Materials and Methods: This retrospective study was conducted at the Malabar Cancer Center, in Thalassery, India, between December 2011 and December 2015. Women who attended the Early Cancer Detection Camps organized for high-risk groups were included in the study. Pap smears were collected from all the women to study the spectrum of changes in their cervical smears to determine a possible correlation between high-risk behaviors and the occurrence of precancerous lesions. Descriptive statistics were used to describe the qualitative variables and Chi-square test was used to determine the association between the abnormalities and demographic variables. A P Results: Out of 289 women enrolled in the study, 277 had satisfactory smears. The median age of the women was 40 years (range, 20–69 years), with majority (44%) in the age group of 30–39 years. Epithelial abnormalities were reported in 53 (19.1%) women. Nonspecific inflammation was observed in 56.6% of the women who were negative for intraepithelial lesion/malignancy (NILM), Candidiasis was seen in 13 (4.7%) women and bacterial vaginosis in 8 (2.9%). Younger women had a significantly higher number of epithelial abnormalities than older (P = 0.01). The highest prevalence of intraepithelial lesions was observed in women in the childbearing age group. Conclusions: The high frequency of epithelial abnormalities emphasizes the need for cervical cancer awareness and prevention campaigns. Periodic cervical smear examination for these vulnerable groups could be a feasible option for the early detection of cervical cancer. The Pap smear test is a rapid, noninvasive, simple, low-cost, and effective diagnostic method for the early detection of cervical cancer in high-risk groups.