Pap Smear Cytological findings in women with abnormal visual inspection test results referred to Kenyatta National Hospital

Citation:
PJ C, C S-K, W W, LW M. "Pap Smear Cytological findings in women with abnormal visual inspection test results referred to Kenyatta National Hospital." East African Journal of Pathology. 2015;2(1):8-12.

Abstract:

Background: The challenge of cost in establishing cytology and/or Human Papillomavirus (HPV) mass screening for cervical cancer in resource limited countries prompted adoption of visual inspection techniques as alternative tests despite them having low specificity.
Objectives: To determine the pattern of cervical intraepitheliallesions and infections in women with abnormal visual inspection test results referred to Kenyatta National Hospital (KNH).
Methodology: A descriptive cross-sectional study was conducted at KNH where women who were referred to this facility after having abnormal visual inspection test results were recruited.
Results: Of the 232 participants recruited, 57(24.6%) had a report of atypical squamous cells of undetermined significance (ASUCS) or worse as follows; 5(2.2%) were ASCUS, 13(5.6%) were low grade squamous intraepithelial lesions (LSIL), 4(1.7%) were atypical glandular cells (AGC), 1(0.4%) was atypical squamous cells cannot exclude high grade (ASC-H), 20(8.6%) were high grade squamous intraepithelial lesions (HSIL) and 18(7.8%) were reported as having carcinoma on cytology. Of these abnormal results 3(1.3%) were from 33 women (14.2%) more than 50 years of age who were also recruited in this study. Infections were detected in 1 (4.7%) of the study participants.
Conclusions and recommendations: Pap smear was useful as follow-up test as it reduced number of referrals for definitive diagnosis to 16.8% while sparing the rest (83.2%) from unnecessary treatment. Pap smear is therefore recommended as follow-up test in women with abnormal visual inspection test results. Increase awareness to service providers and the general public about the Government Policy on the use of visual inspection tests in women more than 50 years of age since 14.2% were inappropriately screened by the visual inspection test.

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