Clinical correlation of cervical cancer screening using Pap smear test.

Abstract

BACKGROUND AND OBJECTIVES Cervical cancer (CC) has a long preinvasive stage, which allows for preventive detection and possible cure. In this study, this stage was a target stage to investigate women with precancerous lesions by applying the Papanicolaou (Pap) smear test and comduct performing a correlation study.s. PATIENTS AND METHODS A 2-year cross-sectional study was conducted, in which 200 married women (21-60 years old) participated in the investigation, which included women with Pap test abnormal results (atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LSILs), and high-grade squamous intraepithelial lesions (HSILs)). These results were used to perform a polymerase chain reaction (PCR) test to detect the presence of human papillomavirus (HPV) of (6 and 11), a low-risk type, and (16 and 18), a high-risk type with colposcopy examination and colposcopy-guided biopsy, if needed for women with abnormal colposcopy outcomes. The treatment, per severity and disease stage, was applied. RESULTS The clinical presentation and Pap smear results of women enrolled in the study were as follows: 82.5% women were asymptomatic, postcoital bleeding (PCB) was seen in 17.0%, and intermenstrual bleeding was seen in a single case (0.5%). The history of sexually transmitted diseases was seen in 2.5% of the subjects. Pap smear results were as follows: no remarkable pathology was seen in 36.0%, inflammatory evidence was seen in 32.0%, ASCUS was seen in 19.0%, LSIL was seen in 7.5%, and HSIL was seen in 5.5% of the subjects. Regarding the HPV, the infection was negative in 95.0%, low-risk virus strains were seen in 1.5%, and high-risk viruses were seen in 3.5%. Low-risk HPV included 6, 11, and 42, whereas the high-risk group included five cases of HPV16 and two cases of HPV 18. CONCLUSIONS The present work presents the Pap smear test as a highly useful, easy, technically safe, and cost-effective tool for detecting cervical epithelial precancerous lesions, which can be used as a routine screening technique for better treatment outcomes and reducing mortality rates. The power of detection of these lesions can be potentiated when using the Pap test and HPV-PCR test together.