Deepa, K (2013) A study on the prevalence of abnormal cervical cytology using pap smear as a screening procedure among the attendees of female STD Out Patient Department. Masters thesis, Madras Medical College, Chennai.
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Abstract
INRODUCTION: Globally, Sexually transmitted infections are a major cause of morbidity. The World Health Organization recommends the use of term “Sexually transmitted infections”(STI) instead of “sexually transmitted diseases” (STD)1 because, sexually transmitted infections may remain symptomless without resulting in disease or they may also end in abortive form. Human Papilloma Virus (HPV) is one of the most common cause of STI’s in the world. Genital HPV, the known cause of cervical cancer is a very common sexually transmitted disease. Upto 70% of genital Human Papilloma Virus (HPV) infections are subclinical. This Sexually Transmitted Infection, HPV plays a pivotal role in the development of squamous cell carcinoma and adenocarcinoma of genital tract. In latent infections, the HPV viral DNA can be isolated with no morphological lesions. Genital HPV infection can be detected by clinic al examination, histology, cytology or molecular analysis. Genital HPV infection, which is often subclinical may be detected during cervical smear test ie PAP smear. AIMS AND OBJECTIVES: A Study on prevalenc e of abnormal cervical cytology using PAP smear as a screening procedure among the attendees of female STD OPD. • To study epithelial c ell abnormality. • To study the associated STIs. • To detect benign cellular changes. • To reinforce the practice to do PAP smear routinely. MATERIALS AND METHODS: Study Design: Cross-sectional study. Study Group: 500 female patients were enrolled in the study female. All the female patients attending the STD OP Department. The ethical committee clearance was obtained and informed consent was taken from the recruited women. Inclusion Criteria: • All the women aged 19 and above after vaginal sexual exposure. Exclusion Criteria: • Pregnant Women & lactating women. • Females during their menstrual cycle. • Women below 19 years. • Females before vaginal intercourse. • Women who had a total hysterectomy for causes other than cervical cancer. SUMMARY: In this study the following observation has been made. 1. In this study the prevalence of abnormal cervical cytology was found to be 9.2% . Among the 48 abnormal cytology smears, 4 patients had carcinoma (8.6%), 3 patients had HSIL (6.5%), 6 patients had LSIL (13.0%) and 33 patients (6.6%) had atypical cells on cytology among 500 patients. 2. Among the 46 cases of abnormal cytology 22 (47.8%) patients belonged to the age group of 26 -35 and 12 (26%) patients belonged to the age group of >45. Bimodal age distribution of abnormal cervical cytology has been noted. 3. 43.4% of women who had abnormal cytology reside in urban area. 4. 18 (39%) patients out of 46 patients found to have abnormal cervical cytology were housewives.12 (26%) patients were coolie. 5. 86% of the 46 women with the abnormal cervical cytology belonged to low and middle income group. 6. Among 46 patients, 29 (63%) women were in the primary education level. 7. Women having more than 3 children had increased prevalence (17%) of abnormal cervical cytology, as compared with the women having 2 children (9%). 8. Women with multiple partners had increase prevalence of abnormal cytology (21%) compared to the women who had s ingle partner (9%). 9. Out of 17 patients, who had been on OCP pills for contraception 11.7% had abnormal pap smear in contrast, 2 patients who practiced barrier contraception both (100%) had normal cervical cytology reading. In this study maximum number of patients under gone permanent sterilization. 10. Prevalence of abnormal cervical cytology is more among women with increasing years of married life .out of 46 women 21 (45.6%) had been married since more than 15 years and 13 (28.2%) of them had been married since 10 - 15 years. 11. On spouse assessment genital ulcer (4.3%) and balanoposthitis (2.1%) were found to be associated with abnormal cytology of their partners. 12. Among 15 women who’s spouse had extra marital contact 6 (40%) of them had abnormal cervical cytology in contrast in women with the spouse with no extra marital contact only 1% had abnormal cervical cytology. This is found to be statistically significant. 13. Abnormal cervical cytology was found to be greater among women who are not living with the spouse 16.9% compared to the women living with the spouse 8%. Women not living with the spouse include commercial sex workers, widowed, separated and divorced. This increased prevalence in this group may be attributed to multiple partners in them. 14. In this study 9 women were referred through their male partner to our STD OPD, among them 4 (44.1%) had positive findings for abnormal cervical cytology. CONCLUSION: • In this study we found 9.2% of prevalence of abnormal cervical cytology and inflammatory pap smear were found in 61.2%. Hence the yield of screening in STD clinics will be higher in STI clinics, than in other clinics. • The risk factors found to be associated with abnormal cervical cytology includes reproductive age group, lower socio-economic and lower educational status, multiparty, multiple partners, associated other sexually transmitted diseases. • Early screening and detection of dysplasia will reduce the morbidity and mortality associated with carcinoma cervix. • Inflammatory pap smear were found to be 62.1%. This inflammatory pap smear warrants, repeated pap smear after treating the infection followed by repeat pap smear in 3 months, and 6 months. Persistant inflammatory cytology warrants further investigations and follow up.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | prevalence ; abnormal cervical cytology ; pap smear ; screening procedure ; attendees ; female STD Out Patient Department. |
| Subjects: | MEDICAL > Dermatology Venereology and Leprosy |
| Depositing User: | Punitha K |
| Date Deposited: | 21 Jun 2018 14:22 |
| Last Modified: | 23 Jun 2018 02:43 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8549 |
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