Study of cervical cytology and its correlation with clinical and histopathological findings

Background: Cancer of the cervix is the second most common cancer among women in the world. It accounts for 12% of all cancers in females. This study aims to evaluate the pattern of cervical cytology and its correlation with clinical and histopathological findings. Materials and Methods: This is 10 years retrospective and prospective study, in which all the Papanicolaou (Pap) smears were reported as per the 2001 Bethesda system. Clinical and histopathological correlation was done in cases where cervical biopsy or total hysterectomy specimens were available. Results: A total of 3791 Pap smears were studied with respect to age group, clinical signs and symptoms, and cytology findings. Cervical biopsy correlation was done in 200 cases. Most of the patients were in age group of 31–40 (35.61%) years. The Pap smear findings revealed 88.02% as negative for intraepithelial lesion or malignancy (NILM), 5.99% epithelial cell abnormality (ECA), and 5.99% were unsatisfactory. ECA comprised atypical squamous cells of undetermined significance (ASCUS) with 2.98%, low-grade squamous intraepithelial lesion with 1.19%, and high-grade squamous intraepithelial lesion with 0.66%. There were 36 cases (0.95%) of malignancy. Sensitivity, specificity, and positive predictive value of Pap smear in diagnosing ECA and malignancy were 89.47%, 88.70%, and 82.92%, respectively. Conclusion: Pap smear test is ideal screening method for cervical carcinoma. Nonspecific inflammation and ASCUS were most common finding among NILM and ECA group, respectively. Biopsy is considered to be the gold standard for carcinoma cervix provided that it is taken from representative areas.