Correlation of cervical pap smears with histopathological study of cervical biopsies: A hospital-based study

Background: Cervical cancer is the second commonest cancer among women accounting for 17.7% among all cancers in women. The high incidence of disease in developing countries is mainly due to absence of effective screening programs. The Papanicolaou (Pap) smear is widely employed for initial screening of cervical epithelial changes to detect early precancerous lesions.
Objective: To correlate the cervical cytological findings with histopathological diagnosis using PAP and haematoxylin and eosin stains respectively.
Methods: A prospective study conducted in tertiary health care centre over a period of 6 months. Out of 680 PAP smears, 100 cases were selected who were above 21 years and corresponding histopathological samples were received in the form of cervical biopsy. The data was collected and compiled in MS Excel and analysed using SPSS (Version 26.0). The variables were expressed as frequency and percentages and p value <0.05 was considered as statistically significant.
Results: In this study, most common age was between 41-50 years (30%) and were multiparous (77%). The most common presenting complaint was white discharge per vagina (34%) followed by abnormal uterine bleed (29%). On PAP smear maximum cases were reported as NILM(64%), followed by ASCUS(19%), LSIL(11%), HSIL(4%), SCC(1%) and Adenocarcinoma(1%). On histopathology 45% were diagnosed as chronic cervicitis, chronic cervicitis with squamous metaplasia(32%), CIN I(9%), CIN II(4%), CIN III(8%), SCC(2%) and Adenocarcinoma(1%). Overall sensitivity of Pap smear was 86%, specificity 79%, positive predictive value 55%, negative predictive value 95% and accuracy of 81%.
Conclusion: Hence we conclude that, maximum cases diagnosed on PAP smear correlated with histopathological diagnosis from cervical biopsy. Therefore it should be encouraged as effective screening method to reduce incidence and mortality caused by cervical cancer.