Cytological Analysis of Cervical Papanicolaou Smears in a Tertiary Hospital in Calabar, Nigeria

Background: Cancer of the cervix is caused by a virus called human papillomavirus (HPV) which infects the uterine cervical epithelium. The Papanicolaou smear is a type of exfoliative cytology. Exfoliative cytology is the study of cells desquamated or shed from the body surfaces (e.g. cervix) or lesions for the purpose of diagnosis or cytological analysis.

Aim: To do a cytological analysis of cervical Papanicolaou smears in a tertiary hospital in Calabar, Nigeria.

Study Design: Retrospective prevalence study design.

Study Place and Duration: The study was done at the Department of Pathology, University of Calabar Teaching Hospital, Calabar on cervical smear analyzed between January, 2011 and December, 2013.

Methodology: This is a retrospective prevalence study of the entire cervical smear (conventional smears) analyzed at the Department of Pathology, University of Calabar Teaching Hospital from January 2011 to December 2013. The relevant information including sociodemographic data, clinical information and diagnosis of the subjects were obtained from the medical records/cytology register and the information was analyzed.

Results: A total of 525 Pap smear were analyzed during the study period. The age range of the patient is between 18 years and 90 years. The mean age of the subjects is 43 years ± 3 SD. The age group with the highest prevalence is the 41-50 years group making up 32% of the subjects followed by 31- 40 years with a prevalence of 29.5%. The group with the lowest prevalence is the 81 – 90 years with a prevalence of 0.6%. The diagnosis with NILM (negative for intraepithelial lesion or malignancy) make up 83% of the total diagnosis, followed by high grade intraepithelial lesion – HSIL (6%), low-grade squamous intraepithelial lesion – LSIL (6%), Inadequate (4%) and atypical squamous cell of undetermined significance - ASCUS (1%).

Conclusion: Pap smear results negative for intraepithelial lesion or malignancy (NILM) was the commonest diagnosis among the patients who presented for cervical cancer screening. Having a larger number of females without any cervical lesions come for cervical cancer screening is a welcome development that would enable the detection and appropriate treatment of intraepithelial lesion if they develop.