Papanicolaou Smear in Abuja Revisited

AY Isah, JA Adaji, GO Akaba, OP Oluwole

Abstract


Background: Papinicolaou smear has been established
as a cost effective screening method for Carcinoma of the
cervix and had been used with celebrated successes in
developed societies. Its utilization has remained
abysmally low in Africa with attendant alarming rate of
overt advanced cancer among her female population.
Recent government public outreach programs abound
and there is need to evaluate the effectiveness of these
campaigns on the outcome of smear results with a view of
future adjustment in outreach strategy.
Objectives: To review the results of Pap smears
conducted in University of Abuja Teaching Hospital with a
view of documenting the prevalence of positive smears
among the study population.

Materials and Method: A three year retrospective
study of Pap smears that were carried out at the
University of Abuja Teaching Hospital between January 1,
2010 and December 31, 2012. The records of the patients
were retrieved from medical record Department and
analysed for age of the patient, parity, educational status,
marital status, findings on vaginal examination,
indication for pap smear and Pap smear results. The
results were presented and discussed using simple
percentages.
Results: One thousand two hundred and seventy four
(1274) women had cervical smears during the study
period. Ninety eight percent of patients were having their
cervical screening for the first time at the mean age of
39.13±9.7 years. Positive Pap smear result was obtained in
39.5% of symptomatic and 24.4% of asymptomatic
patients while Negative smears were recorded in 63.8% of
the patients. Human Papilloma Virus (HPV) changes
occurred in 5.7%, while atypical cells of undetermined
significance (ASCUS) were observed in 4.9% of the
patients. Low grade squamous intraepithelial lesions
(LSIL) were the commonest cervical smear abnormality
observed in 9.6% of the patients.

Conclusion: The mean age at first screening remain
high with corresponding high rate of abnormal smear in
both symptomatic and asymptomatic patients. The
provider initiated counseling and testing is encouraged for
early identification and treatment of precancerous lesions of Carcinoma of Cervix. Development and strict adherence of a National guideline for free routine screening of all women of reproductive life may increase the uptake.


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