Clinical correlation of cervical cancer screening using Pap smear test

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.