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Abstract
VALIDITY OF PAP SMEAR IN CORRELATION WITH COLPOSCOPY IN SCREENING OF MALIGNANT AND PREMALIGNANT LESION OF THE CERVIX, IRAQ
*Dr. Rasha Muhi Abdulsahib, Lamees Adnan Shubber and Besmah Mohammed Ali
ABSTRACT
Introduction: Papanicolao (Pap) smear remains the most available, feasible, and cost-effective tool for screening of the cervix premalignant and malignant lesions. Via the pap smear, several premalignant lesion of the cervix including the cervical dysplasia and inflammatory lesion could be diagnosed in early stage of the disease. However, the accuracy of the pap smear has been reported to range between 53 and 78% between various studies with the same method of interpretation. The sensitivity and specificity of the pap smear in detecting high-grade lesions of the cervical intraepithelial neoplasia (CINII and CINIII) have been shown to be 55.4 and 96.8%, respectively. The colposcopy is another screening tool for premalignant lesion of the cervix which is not available in all the centers and is expensive. Objectives: determine validity of pap smear test related with colposcopy investigation. Methods: This cross-sectional descriptive study on 85 married or sexually active reproductive-age women (21–78 years) who they attended in Al Yarmouk Teaching Hospital, in Baghdad, Iraq. Data was collected from the medical records in the cervical cancer unit in the hospital for the period from (1/1/2022 to 1/1/2023). The collected data were coded and entered into SPSS 16.0 (Statistical Package for the Social Sciences (SPSS) 16.0 by IBM) (SPSS for windows, Rel. 16.0.2007, SPSS Inc., Chicago, IL, USA). The categorical data were analyzed by frequency (n) and percentage. Results: The pap smear results were positive 46 (54.11%) patients while colposcopy was found to be abnormal in 30 (35.30%) patients. The results of biopsy and histopathology examination revealed 25 (29.41%) positive and 60 (70.58%) negative results. The detailed results of each diagnostic study are summarized in Table2. The diagnostic accuracy of the pap smear was evaluated based on the histopathological results (gold standard). The sensitivity and specificity of pap smear were found to be 66.6% and 96.7%, respectively. In the same way, the PPV and NPV of the pap smear were calculated to be 67.6% and 95.9%, respectively. The overall diagnostic accuracy of the pap smear was found to be 93.9%. Conclusion: In conclusion, the results of this study demonstrate that pap smear is a good valid diagnostic accuracy in detecting cervical premalignant lesions when correlated with colposcopy.
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