A study on cervical cancer screening in symptomatic women using Pap smear in a tertiary care hospital in rural area of Himachal Pradesh, India

Background: Cervical cancer is the most common cause of death among women in developing countries. India has the highest age standardized incidence in South Asia at 22. An attempt was made to know the impact of cancer screening programmes in place since 1975 in India, and to do cytological screening in symptomatic women. Material and methods: 200 women in the age group of 21–65 years who attended Gynaecology Outdoor Patient Department (OPD) who consented to participate were screened by Pap smear testing. Women who were pregnant, and known or treated case of cancer cervix were excluded from the study. Pap smears were made with conventional method. Results: None of the women had Pap smear testing in their life earlier. Only 5% women knew that the tests are available that can detect cervical cancer. All the women were married and in stable marital relationship. Mean age was 38.6 years. Most of the women were parous, had poor socio-economic status and had never used tobacco in any form. Vaginal discharge was the commonest complaint followed by inter-menstrual bleeding. 56% smears were reported as NILM, 32.5% inflammatory, 1.5% had other non-specific findings. ASC-US was in 1%, LSIL in 5.5% and HSIL in 2.5% women. Overall sensitivity and specificity for detection of LSIL were 76.9% and 96.2% and those for detection of HSIL were 66.6% and 97.6%. Conclusions: Pap smear is highly sensitive and specific method in detecting pre-cancerous lesions of cervix. Community needs to be enlightened about Pap test through diffuse educational activities