Title: Cytological Pattern of Cervical Papanicolaou Smear According to 2014 Bethesda System: A Study Conducted in Tertiary Care Central India, Indore
Authors: Dr Sachin Sharma, Prof. Dr C.V. Kulkarni, Prof. Dr Meena Mittal, Dr Rakesh Mehar, Dr Ankesh Kumar Jain, Dr Priya Jain
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.113
Abstract
Introduction
Cervical cancer ranked second among most commonly diagnosed cancer and in less developed countries it is third leading cause of cancer related death among females[1,2,3] It is estimated that each year, 527,000 new case occur and 275, 000 deaths. Globally, 15% of all cancer in females is cervical cancer.[2,4]. In India about 20% of all cancer related deaths is due to cervical cancer in women and is the number one cause of death in middle aged Indian women.[5] Also, India has 432.20 million women at risk for cervical cancer, annual number of cervical cancer cases is 122,844, annual number of deaths is 67, 4773.[6]
Cancer cervix is a multifactorial disease. Major risk factors are age[7,8], illiteracy, low socioeconomic status, early menarche, marital status, early marriage, early first childbirth, age at last child birth, multiparity, abortion, multiple sexual partners, late menopause, genital infection, poor genital hygiene, tobacco use, passive smoking and contraceptive use [9-13]. Other risk factors includes co-infection with Chlamydia trachomatis, non-use of condoms by partners and nutritional factors.[14-19]
Human Papilloma virus (HPV) infection is the most important risk factor.[20] It has been shown recently that cervical cancer is strongly associated with the presence of high risk or oncogenic Human Papilloma virus (HPV) types (up to 100%).[21,22]
Cervical cancer is a potentially a preventable disease through early detection using several screening techniques.[23] Therefore, the main focus is on the secondary prevention through early detection which is mainly done by cytology. This will lead to treatment of precancerous lesion itself before cancer develops hence reducing the incidence of cervical cancer.[24] In Screening by cytology we look for pre- cancerous changes in the cervix that could develop into cervical cancer.[3] Cytomorphologically abnormal epithelial cells are best demonstrated by the Papanicolaou test. The initial and most important step in cervical cancer screening was the introduction of Papanicolaou (Pap) testing[25,26]. The 2014 Bethesda System has been introduced recently, which is used for reporting cervical smear in our study.
