Pap Smear Reports Research Articles

HPV DNA status and clinical history of patients are supplements for accurate reporting of the cytological Pap smear

The present study was aimed at showing the importance of HPV DNA status and the clinical history of the patients required by the cytologist for accurate reporting. A total of 1250 symptomatic women who attended the gynaecology outpatient department of the Mahavir Cancer Sansthan and Nalanda Medical College, Patna, for pap smear examinations were screened and recruited for the study. Due to highly clinical symptoms out of the negative with inflammatory smears reported, one hundred and ten patients were randomly advised for biopsy and HPV 16/18 DNA analysis by a gynaecologist to correlate negative smears included in the study. Pap smear reports revealed that 1178 (94.24%) were negative for intraepithelial lesions (NILM) with inflammatory smears, 23 (1.84%) smears showed low-grade squamous intraepithelial lesions (LSIL), 12 (0.96%) smears showed high-grade squamous intraepithelial lesions, and 37 (2.96%) smears showed an atypical squamous cell of undetermined significance (ASC-US). A biopsy of 110 out of 1178 (NILM) patients revealed that 15 (13.63%) women had cervical cancer, 29 women had CIN I, 17 women had CIN II + CIN III, 35 women had benign cervical changes, and 14 women had haemorrhages. On the other hand, HPV 16/18 DNA was detected as positive in 87 out of 110. The high positivity of HPV in biopsied cases where frank cervical cancer and at-risk cancer were also observed in the negative smear-screened patients reveals that the HPV status and clinical history of the patients will be quite helpful to the cytologist for accurate reporting, and suggests that a negative HPV DNA result may be a stronger predictor of cervical cancer risk than a negative Pap test.

Comparison of Conventional Pap Smear With Liquid-based Cytology for Screening of Cancer Cervix

Abstract Objective: The objective of the study was to compare conventional Pap smear (CPS) and liquid-based cytology (LBC) by the split technique method in terms of satisfactory/unsatisfactory smear, the prevalence of inflammatory smear, and cellular atypia. Materials and Methods: This cross-sectional study was carried out between 2017 and 2019 after obtaining ethics committee approval. A total of 200 women were recruited for the study attending the gynecology outpatient clinic with various symptoms, such as discharge per vaginum, dysmenorrhea, infertility, and pain abdomen, and after obtaining written informed consent. Pregnant women, women with pelvic inflammatory disease, and cases with obvious cervical lesions or growth were excluded. Pap smear was taken with a Rovers Cervex-Brush. The split sample technique was followed wherein using one side of the brush conventional slide was prepared and fixed with cytospray. The brush head was detached and suspended in the preservative fluid for LBC. Both CPS and LBC were sent for examination. The same experienced pathologist examined the samples. The qualitative variables were compared using the Mcnamer test to compare the prevalence of unsatisfactory smear, inflammatory smear, and cellular abnormalities between CP and LBC. The categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± standard deviation and median. P < 0.05 was considered statistically significant. Results: The maximum number of patients (62.5%) belonged to the fourth decade of life. The mean age was 39 years. A total of 93% of women were from the urban areas while 7% belonged to the rural areas. The majority of the women (78.5%) were multiparous and around 43% were second para. Pap smear reports were satisfactory in 93.5% of women in CPS, while 99% of reports were satisfactory in LBC. The difference between CPS and LBC in terms of the prevalence of satisfactory/unsatisfactory smear was statistically significant with a P = 0.0064. Dense inflammation reported by all LBC smears was reported as the same in CPS. The strength of agreement between CPS and LBC was not strong in terms of different grades of inflammation with a kappa value of 0.24. There was no difference in the reporting of cellular atypia between both methods. Conclusions: CPS and LBC are equal in terms of detection of inflammation and epithelial cell abnormality. Infections were also detected by both the screening methods CPS and LBC. The only thing which makes LBC better is the rate of satisfactory smears and the benefit of adding human papillomavirus DNA testing possible only in LBC.

Cytologic Surveillance Versus Immediate Referral to Colposcopy for Women with a Cervical Cytology Diagnosis of ASC-US and LSIL in the Absence of HPV DNA Test

Background and Objectives: Cytology screening programmes decrease the risk of cervical cancer by detecting the precancerous changes. Treating these reduce the likelihood of developing invasive disease in future. The management strategies for severe precancerous changes are well established, however, this is not the case with minor cytological abnormalities like ASCUS or LSIL especially when a triage strategy like HPV testing is not easily available. This study aims to assess whether immediate referral to colposcopy is better than cytologic surveillance for women with a cervical smear diagnosis of ASC-US and LSIL in a context where HPV test is either unavailable or not affordable. Methods: A prospective study was conducted at a tertiary care hospital between January 2021 and November 2022. Total 126 women with a Pap smear report of ASC-US or LSIL were recruited to receive either cytologic surveillance (Group A) or immediate colposcopy (Group B), with 63 women in each group. Adherence to follow up and eventual histologic diagnosis of HSIL on colposcopically directed biopsy (CDB) and/or Loop electrical excision procedure (LEEP) were considered as the main study end-point. Results: Significantly more women defaulted from the cytologic surveillance group than the immediate colposcopy group (p=0.00001). In group B, using CDB and LEEP, 5 additional high-grade lesions were detected. However, the p value was not significant when compared with the cytologic surveillance group (p=0.360). Interpretation and Conclusions: Cytologic surveillance is fraught with a poor compliance rate. In the absence of HPV DNA test, minor cytologic abnormalities should undergo immediate colposcopy if follow up cannot be ensured. The high persistence rates of ASC-US and LSIL (41.18% and 35.71%), as well as the high progression rate of LSIL in the cytologic surveillance group, also underscore the necessity for these women to undergo immediate referral to colposcopy.

COLPOSCOPIC EVALUATION OF POST-MENOPAUSAL WOMEN WITH NORMAL CERVICAL CYTOLOGY

1. Introduction The most common genital cancer seen in Indian women is Carcinomacervix Its incidence is approximately 1 in 53 Indian women during their lifetime compared to 1 in 100 in developed countries. In women ≥ 50 years where the lifetime risk of cervix cancer is estimated as 3.5%, which can be reduced to 0.8% with screening. Pap smear evaluation alone is inadequate for predicting the precancerous lesions in postmenopausal women due to hypoestrogenic changes of menopause which makes it difcult to differentiate atrophic cellular changes from other pathologic conditions, giving more false negative results which can be reduced if combines with colposcopy examination and guided biopsy wherever needed 2. Aim & Objective To diagnose intraepithelial lesions in postmenopausal patients with normal cytological ndings and to assess the usefulness of cytological screening, colposcopy, and colposcopy-directed biopsy in these patients. 3. Material And Method- A retrospective study was carried out from 1st January 2018 to 31 October 2022 at a colposcopy clinic, in district Shivpuri M.P. on 104 post-menopausal females of age group 45-68 years. After detailed history and examination, a pap smear in all 104 patients was taken. All patients with negative cytology reports for Intra epithelial lesions with persistent symptoms and suspicious signs were subjected to colposcopy. 23 Patients with positive Colposcopic ndings were subjected to Colposcopic guided biopsy. histopathological evaluation was done. 4. Result This study analyzed 104 postmenopausal patients who had Pap smear reports with NILM (Negative for intraepithelial Lesion or Malignancy). 58% of the patients were referred by other Doctors. The most common post-menopausal age group nd in this study was between 45-55 (52.88%), Most of the patients were of a low socioeconomic group (54.81%), Multipara (3-5 parity 66.35%). with a history of menopause of 5-10 years (49.04%) duration. Only 5.77% of patients had 3 Pap smear reports with them, and a history of smoking was present in 6.73% of cases. The most common presenting symptom was discharge PV (47.11%) followed by Foul smelling bloody discharge (14.42%). Post-coital bleeding (12.5%), Post-menopausal bleeding (8.65%), and dyspareunia (4.80%). On colposcopy, (77.89%) of cases had normal Colposcopic ndings while (22.11%) had abnormal Colposcopy ndings. In 17.30% of cases, LSIL was suspected, in 4.80% of cases HSIL was suspected on colposcopy Colposcopy-guided biopsy was done in 23 (22.11%) patients with suspected CIN. On histopathology 9.61% of cases were positive for intraepithelial lesions, CIN1 was found in 7.69%, and CIN2 in 1.92%. Carcinoma in situ and Invasive carcinoma were not found in any case. 10(9.61%) out of 104 patients had cervical intraepithelial neoplasia diagnosed on colposcopy-guided biopsy and histopathology report. 5. Conclusion- In our study, despite the Pap smear report as NILM (Negative for intraepithelial lesion or malignancy). ,10(9.61%) out of 104patients had cervical intraepithelial neoplasia diagnosed on colposcopy guided biopsy, thus we recommend, the combined use of cervix cytology, colposcopy, and histopathology in postmenopausal cervix cancer screening evaluation to improve the diagnosis of the cervical intraepithelial lesion.

Cytomorphological spectrum of cervical pap smear reports using the 2014 bethesda system for reporting cervical cytology; A two year study in a tertiary care hospital at Puducherry, India

Background: Cancer cervix is fourth most common cancer in world and second most common in India. It is considered as a preventable disease when identified at an early stage by pap smear screening test. Aim: This study aims to explore the use of conventional pap smear for the diagnosis of various cytomorphological spectrum of cervical pap smear reports using “The Bethesda System for reporting cervical cytology 2014” (TBSRC 2014), to analyze the clinical and demographic data of the patients, and also to characterize the age pattern of various pap smear findings/results and prevalence of abnormal pap smears among various age groups as well. Methods: In this retrospective study, a total of 1650 conventional pap smears of women who attended gynaecology OPD in our tertiary care hospital, Puducherry, India between July 2018 to July 2020 are evaluated and reported as per TBSRC 2014 and the results were tabulated and analysed accordingly. Results: 1376 women had Negative for Intraepithelial lesion/ Malignancy (NILM) and 33(2.3%) had Epithelial cell abnormality (ECA). Organisms (15.3%) is the one of the frequent patterns of NILM in the study involving predominantly 21-40 years age group (11%).

Cytomorphological spectrum of cervical Pap smear reports using the 2014 bethesda system for reporting cervical cytology

Cancer cervix is fourth most common cancer in world and second most common in India. It is considered as a preventable disease when identified at an early stage by pap smear screening test. This study aims to explore the use of conventional pap smear for the diagnosis of various cytomorphological spectrum of cervical pap smear reports using The Bethesda System for reporting cervical cytology 2014 (TBSRC 2014), to analyze the clinical and demographic data of the patients, and also to characterize the age pattern of various pap smears findings/results and prevalence of abnormal pap smears among various age groups as well. In this retrospective study, a total of 1650 conventional pap smears of women who attended gynaecology OPD in our tertiary care hospital, Puducherry, India between July 2018 to July 2020 are evaluated and reported as per TBSRC 2014 and the results were tabulated and analysed accordingly. 1376 women had Negative for intraepithelial lesion/ Malignancy (NILM) and 33(2.3%) had Epithelial cell abnormality. Organisms (15.3%) is the one of the frequent patterns of NILM in the study involving predominantly 21-40 years age group (11%). Almost all cases of Epithelial cell abnormality (2.3%) involve >44 years of age.

Cervical Cancer Screening in Patients with Total Hysterectomy in a Diagnostic Center at Mexico City.

Background:The aim of this study was to outline the Pap smears rate done in women with total hysterectomy, sent to an urban diagnostic center that attends Mexican Government workers in the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE: State´s Employees´ Social Security and Social Services Institute) at Mexico City.Methods:It was a retrospective study on Pap smear reports taken in 2017. The reports came from users of four family medicine clinics and a general hospital´s gynecology service. Demographic facts, instruments for collection, kind of insurance (ISSSTE-insurance or non-insurance), and total hysterectomy history were evaluated.Results:From 4989 reports, 600 (12%) had a total hysterectomy history. In the patients with ISSSTE-insurance, 586 of 4618 (12.68%) had a Pap smear whereas in the patients with non-insurance, only 14 of 371 (3.7%) had it, and this difference was significant (P < 0.00001; OR 3.7, 95% IC 2.15-6.36).Conclusions:Although Pap smear is not indicated in women with total hysterectomy, this study is still carried out frequently.

The magnitude and predictors of cervical squamous intraepithelial lesions among women in Enugu, Nigeria: a cross-sectional study of women in a low-resource setting.

Introductionthe prevalence of cervical squamous intraepithelial lesion is not well appreciated in most low-income countries. The study aimed to determine the level of awareness, prevalence and the pattern of squamous intraepithelial lesions and predictors for abnormal Pap smear reports (development of pre-malignant lesions of the cervix) among women attending various clinics in a tertiary health facility in Enugu, Nigeria.Methodsa cross-sectional study of 207 female patients attending various clinics of Enugu State University Teaching Hospital, Parklane, Enugu between June and August 2017 was undertaken. Structured interviewer-administered questionnaires were used for data collection while cervical smears were collected from the patients and sent for cytology. Data analysis was done using the Statistical Package for the Social Sciences (SPSS) version 22.0. The results were presented as means, standard deviations, frequencies and proportions. Pearson´s Chi-square test was used to test for associations between categorical variables and statistical significance was set at a p-value of < 0.05.Resultsthe levels of awareness of cervical cancer and the screening methods among the respondents were 76.8% and 36.7% respectively. The overall knowledge of cervical cancer and its screening was poor (6.8% and 29.0% respectively). The prevalence of pre-malignant lesions of the cervix among the respondents was 15.0% with low grade squamous intraepithelial lesion (LGSIL) having the highest frequency (38.7%). Among all the other risk factors for the development of premalignant lesions of the cervix among the respondents, a report of abnormal pap (positive) smear report was significantly associated with only age ≥35 years (χ2=5.723; p=0.017). The same age of 35 years and above also correctly predicted abnormal Pap smear reports among other factors (AOR = 3.02, 95% CI = 1.16 - 7.89, p = 0.024).Conclusionthe awareness of cervical cancer and cervical cancer screening was high but the overall knowledge on cervical cancer and its screening was very poor among the respondents. The prevalence of pre-malignant lesions of the cervix was high, and the commonest abnormal smear was LGSIL. Only age 35 years and above correctly predicted the occurrence of abnormal Pap smear reports among the respondents.

A Case Report on Ayurvedic Management of Perimenopausal Bleeding

Perimenopausal period is the transitional period where a woman passes from the reproductive to the non-reproductive stage. Abnormal uterine bleeding in the perimenopausal period accounts for 70% of all gynecological problems. Most of the abnormal uterine bleeding in this period is due to endometrial abnormalities. In Ayurveda the condition can be correlated to Asrigdhara. This is the case report of a 54 year aged lady who presented with complaints of excessive bleeding and frequent menstrual cycles since three months. Investigations were done to rule out malignancy. USG report showed endometrial hyperplasia of 17mm with bulky uterus. Pap smear and Colposcopy reports showed inflammatory and CIN I changes with HPV flat lesions respectively. Bleeding stopped after two weeks of internal medication. USG done after six months showed significant reduction in endometrial thickness. Pronounced changes were also seen in Pap smear and Colposcopy findings.

Gynaecological Problems among Elderly Women Living in Old Age Homes of Kathmandu Valley

Ageing is a natural process. The elderly population is increasing in Nepal.When there is presence of diseases, physical inability, and financial harshness, the elderly in Nepal have to face many problems. This study was thus conducted to assess the socio-economic milieu and spectrum of gynaecological problems among women living in old age homes of Kathmandu valley. For this a cross sectional study was conducted in 21old age homes of three districts of Kathmandu valley. In this study, they were 234 particants. Privacy and confidentiality of information about the individual were strictly maintained. One-third of the aged women living in the old age homes belonged to 70-80 years.50.9% were from outside Kathmandu valley, while 49.1% were from the valley. The elderly were mostly not visited by their relatives and friends. Most of them (74.4%) were interested in praying than other activities. Out of the total Urine samples (190), 68.4% were normal, and 9.4% had a urinary tract infection. There were only 15.6% uterine prolapse cases. Out of total, 70.9% of Pap smear report was normal, while 25.1% had inflammatory smear. This study revealed that the old age homes have become a shelter for most of elderly women. The socio-economic condition was poor. Gynaecological probems like UTI, Urinary incontinence were not high but the prolapse cases (uterine proplase, cystocele, rectocele) were remarkably high. Cervical cancer screening through Pap smear showed negative results.

Cervical Intraepithelial Lesions in Women with Persistent Inflammatory Smear on Pap Smear: A Descriptive Cross-sectional Study.

Persistent inflammatory smear is a benign finding on pap test but is associated with premalignant lesion of the cervix. Further evaluation is therefore necessary. This study was done to determine the prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear. This is descriptive observational study conducted in Department of Obstetrics and Gynaecology of tertiary care centre of Nepal from 15th May 2020 to 14th May 2021 after obtaining ethical clearance from Institutional Review Board (Reference no MEMG/IRC/338/GA). Women with two consecutive pap smear reports showing inflammatory findings were enrolled. Colposcopy was performed and Modified Reid's colposcopic index was used to grade the lesions. Colposcopic guided biopsy was taken and tissue sent for histopathology for abnormal colposcopic lesions. Data analysis was done using Statistical Package for Social Sciences version 21 and frequency and percentages were used to present data. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Among 115 women, 57 (49.5%) at 95% Confidence Interval (40.37-58.63) had Cervical Intraepithelial lesions. Among them 48 (41.7%) had low grade intraepithelial lesions and 9 (7.8%) had high grade lesions on colposcopy. The prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear on pap was higher in our study compared to other studies.

Study of Pap Smear as Cervical Cancer Screening: A Prospective Study at a Periurban Tertiary Care Centre

Background: Cancer cervix is fourth most common cancer in the world and second most common in India. In India, cervical cancer is the leading cause of mortality and morbidity amongst women. Methodology:This prospective study was conducted among 200 women undergoing Pap Smear Test at gynecology OPD between January-June 2020. Pap smear test was classified as per Bethesda system. Result: Abnormal pap smear report was seen among 25.5% women. Higher proportion of abnormal pap report was seen among women aged 21-30 years (41.17%), with a duration of married life between 10-20 years 33.3%. The common abnormal pap smear report finding were inflammatory changes and vaginosis. Epithelial cell abnormalities were found among 18 (9%) women. Conclusion: Pap smear test is a simple, affordable, effective, and practical screening test for early detection of cervical cancer, and it decreases morbidities and mortalities due to cervical cancer.

Effectiveness of Pap Smears as Predictor in the Diagnosis of Carcinoma Endometrium at a Tertiary Oncology Centre in India

Endometrial carcinoma is the commonest malignancy of female genital tract in the developed world. No widely accepted screening test exists for endometrial cancer. However, cervical cytology may be useful in predicting endometrial disease. The aim of this study was to review the Pap smears of endometrial carcinoma patients for normal/ abnormal cytology and then correlate with clinico-pathological parameters. This was a retrospective study from January 2008 to December 2013. A total of 226 patients underwent surgery for endometrial cancer at this centre in this duration. Of these, medical records were available in 204 cases. Pap smear reports within previous 6 months of surgery were available in 180 cases. The relevant data of these patients were statistically analysed using standard statistical tests. A p value of ≤ 0.05 was considered significant. The patients were in the age group of 32 to 85 years. A total of 38 (21.1%) cases showed abnormal cytology on Pap test. The cervical cytology of carcinoma endometrium patients was then correlated and statistically analysed with various parameters like age, stage, grade of the disease, histology type and depth of myometrial invasion. The association was significant for higher histologic grade, advanced stage, deeper myometrial invasion and non-endometrioid histology. In our study, the rate of detection of abnormal cervical cytology in carcinoma endometrium is less in early stages but high in advanced stages and in the presence of poor prognostic factors, like higher histologic grade, deeper myometrial invasion and non-endometrioid histology.

Assessment of cervical cytomorphological changes in infertile women undergoing IVF/ICSI

The aim of this study is to assess cervical cytomormophological changes in cervical smears taken from infertile women undergoing IVF/ICSI compared with normal fertile women. A case-control study of 100 cases were included, 50 infertile group and 50 normal fertile control group both in age range between (20-44), Pap smear taken prior to ova pickup in case group and in preovulatory day in control group. The mean age for case group was 28.9 ±5.6 year; and the mean age of control group was 29.7 ±5.5 years with no significant difference between them t=1.99, p=0.5, the most frequent cause of infertility is polycystic ovaries or with polycystic ovarian syndrome which diagnosed in (36%) of patients then (28%) of patients diagnosed with unexplained infertility. Case group has (22%) diagnosed with atypical squamous cells with undetermined significance (ASC-US) while control group has just 1 case (2%) with ASC-US and this affects pregnancy test result since (18%) out of (22%) of patient with (ASC-US) pap smear report has negative pregnancy test. Statistical analysis shows significant correlation between positive cervicitis and negative pregnancy test (P value = 0.04) because (52%) out of (66%) with positive cervicitis has negative pregnancy test.beside a significant relation between positive infection in pap smear report and negative pregnancy test because (30%) out of (34%) with positive infection in pap smear has negative pregnancy test. In Conclusions, infertile women eligible for IVF are more probable to have ASC-US when compared with normal fertile women, ASC-US worsen pregnancy test results in women undergoing IVF/ICSI because (18%) out of (22%) of patient with (ASC-US) have negative pregnancy test.

Detection of cervical intraepithelial neoplasia (CIN) by visual inspection of cervix with acetic acid (VIA) and its comparison to cervical cytology

Background: Cervical cancer is the second most common cancer in women throughout the world, and it is the leading cause of cancer death among women in underdeveloped countries like Bangladesh is preventable and curable if detected at and early stage using proper screening tools. This study was done to see the effectiveness of VIA and find out the CIN and introduce as a complementary to cytology for diagnosing precancerous form of cervix.&#x0D; Materials &amp; Methods: A total 175 subjects were studied &amp; relevant data of cervix related patients have been collected. The data regarding Pap smear, VIA and biopsy have been taken and collected data was analysis by SPSS.&#x0D; Results: Out of 175 Patients VIA positive 53 (30.3%), Pap smear reports, 84 (48.0%) had inflammatory findings and 38 (21.7%) had dysplasia and biopsy result 41(23.4%) CIN positive. Sensitivity of VlA was 90.2%, specificity 88.1%, PPV 69.8%, NPV 96.7% and accuracy 88.6%. Sensitivity of Pap smear reports was 80.5%, specificity 96.3%, PPV 86.8%, NPV 94.2% and accuracy 92.6%.&#x0D; Conclusion: Visual inspection of cervix after application of acetic acid (VIA) is valid as cytology test for the identification of pre-invasive cervical cancer (CIN). Thus VIA is a useful screening method of Cervical Intraepithelial Neoplasia lesion as Pap smear.&#x0D; TAJ 2018; 31(1): 15-20

Assessment of serum estradiol effect on cervical cytomorphological changes in infertile women undergoing IVF/ICSI

Women undergoing IVF procedures tend to have high levels of estradiol hormone because of the drugs used to stimulate egg production, and this may lead to display cervical cytomorphological changes &amp; may affects pregnancy outcome in IVF cycles. The aim of the study is to correlate serum estradiol level on preovulatory day in women undergoing IVF/ICSI with cytomorphological changes in cervix and pregnancy test result. In this prospective case-control study, a total 100 cases were included 50 case group and 50 control group both in age range between (20-44) First blood sample to test serum estradiol taken on day 2 of menstrual cycle in both groups and second blood sample taken in preovulatory in both case and control group. Serum estradiol measured by Minividas. Cervical pap smear taken in preovulatory day in both case and control groups and stained with conventional pap stain then assessed according to Bethesda system 2001. There is non-significant correlation between serum estradiol in preovulatory day and appearance of abnormality in pap smear reports (P value=0.9). There is non-significant correlation between serum estradiol in preovulatory day and pregnancy test result (P value =0.5). In conclusion, serum estradiol does not have an association with IVF outcome and does not affect pap smear outcome.

Using Natural Language Processing to Extract Abnormal Results From Cancer Screening Reports.

Numerous studies show that follow-up of abnormal cancer screening results, such as mammography and Papanicolaou (Pap) smears, is frequently not performed in a timely manner. A contributing factor is that abnormal results may go unrecognized because they are buried in free-text documents in electronic medical records (EMRs), and, as a result, patients are lost to follow-up. By identifying abnormal results from free-text reports in EMRs and generating alerts to clinicians, natural language processing (NLP) technology has the potential for improving patient care. The goal of the current study was to evaluate the performance of NLP software for extracting abnormal results from free-text mammography and Pap smear reports stored in an EMR. A sample of 421 and 500 free-text mammography and Pap reports, respectively, were manually reviewed by a physician, and the results were categorized for each report. We tested the performance of NLP to extract results from the reports. The 2 assessments (criterion standard versus NLP) were compared to determine the precision, recall, and accuracy of NLP. When NLP was compared with manual review for mammography reports, the results were as follows: precision, 98% (96%-99%); recall, 100% (98%-100%); and accuracy, 98% (96%-99%). For Pap smear reports, the precision, recall, and accuracy of NLP were all 100%. Our study developed NLP models that accurately extract abnormal results from mammography and Pap smear reports. Plans include using NLP technology to generate real-time alerts and reminders for providers to facilitate timely follow-up of abnormal results.

Evaluating the Pap Smear Reports of Pathology Laboratories in Ahvaz, Iran

Background & aim: Pap smear is a screening procedure for cervical cancer. The incidence and mortality rate of cervical cancer has decreased up to 90% in the regular screening in women aged 20-65 years. This study aimed to investigate the Pap smear reports of pathology laboratories in Ahvaz, Iran. Methods: In this cross-sectional study, 1,006 Pap smear reports were collected from pathology laboratories via cluster sampling method. Data was analyzed by a self-structured questionnaire. In addition, variables such as age, type of infection, grade of inflammation, metaplastic changes, and epithelial cell abnormalities in cervix were studied in this study. Data analysis was performed in SPSS V.16.0 using descriptive analysis, ANOVA, Fisher’s exact, and Chi-square tests. Results: While no infection was reported in 94.43% (n=950) of cases, the highest incidence rate of infections in the remaining samples (5.56%, n=56) was related to Candida Albicans (4.77%, n=48). Various grades of inflammation were reported in 83.69% (n=842) of the samples. Moreover, the highest grade of inflammation in fungal infections was 2+, whereas the grades in Trichomonas and bacterial infections were 1+ and 3+, respectively. Cervical dysplasia and metaplasia were reported in 0.29% (n=3) and 1.19% (n=12) of the cases, respectively. Conclusion: The prevalence of cervical-vaginal infections, cervical metaplasia, and dysplasia were relatively low in Pap smear reports of laboratories in Ahvaz.

An Audit on Adequacy of Pap Smears

Conventional Pap smear is a commonly done screening test for cervical cancer. Accurate interpretation depends upon the specimen adequacy which is considered to be the single most important quality indicator of “The Bethesda System (TBS)”. To audit specimen adequacy and compare results based on 2014 TBS. Retrospective audit from 1 April to 31 December 2015. Data was collected from case notes and Pap smear reports. A total of 146 Pap smears were done during the study period. Majority of the women (34 %) were between 41 and 50 years. Fifty-five per cent had a small family size of two children. Seventy-six per cent were premenopausal while 34 % were post-menopausal. Transformation zone/endocervical component (TZ/EC) was seen in 87 % of smears. Blood was seen in 2.7 % and inflammatory cells in 59.6 % of smears. All smears were satisfactory for interpretation by the cytologist. In the final interpretation, atrophic smears were seen in 2/146 (1.4 %), low-grade epithelial abnormality and high-grade abnormality were seen in one smear each (0.7 %). Colposcopy and directed biopsy were normal in both. A total of 43.8 % were normal. A total of 53.4 % were inflammatory. In this audit, 100 % smears were satisfactory for interpretation and above the literature standard of 99.5 %.

Using probabilistic record linkage methods to identify Australian Indigenous women on the Queensland Pap Smear Register: the National Indigenous Cervical Screening Project

ObjectiveTo evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first...