title: Colposcopic evaluation of cervix with persistent inflammatory Pap smear: A prospective analytical study.
abstract: BACKGROUND
  Inflammatory Pap smear is the most common report received by a gynecologist. The cervical screening algorithm for benign cellular changes on the Pap smear recommends treatment of infection if indicated and a repeat Pap smear in 4 to 6 months time. If the inflammatory changes still persist, subject the patient to colposcopy. However, in practice, this is not followed, especially in developing countries like ours where proper screening protocols are not available. Hence, a good number of patients in the premalignant stage are being missed. This study was undertaken to evaluate patients with persistent inflammatory Pap smears without atypia using colposcopy.
  
  
  METHODS
  A prospective analytical study of 150 gynecologial patients with persistent inflammatory Pap smear between 2006 and 2008 in an out-patient setting. All of them were subjected to colposcopy and biopsy from the abnormal areas. The incidence of cervical intraepithelial neoplasia (CIN)/invasive carcinoma was calculated by proportions/percentages.
  
  
  RESULTS
  The incidence of invasive carcinoma was <1%. But, the incidence of pre-malignant lesions (CIN) was high (20.9%). CIN 2/3 and carcinoma in situ were present in 6.9% of the cases.
  
  
  CONCLUSIONS
  Patients with persistent inflammatory Pap smears can harbour a high proportion of CIN and hence these patients will need further evaluation.
authors.affiliation: Department of OBGY, JIPMER, Puducherry, India.
authors.forename: Papa
authors.initials: P
authors.lastname: Dasari
authors.forename: S
authors.initials: S
authors.lastname: Rajathi
authors.forename: Surendra V
authors.initials: SV
authors.lastname: Kumar
references.citation: Gynecol Oncol. 2007 Apr;105(1):157-65
references.pmid: 17229459
references.citation: J Fam Pract. 1994 Jan;38(1):40-4
references.pmid: 8289050
references.citation: Acta Cytol. 1998 Nov-Dec;42(6):1481
references.pmid: 9850666
references.citation: Obstet Gynecol. 2003 Aug;102(2):417-27
references.pmid: 12907124
references.citation: Acta Cytol. 1994 Jul-Aug;38(4):531-6
references.pmid: 8042417
references.citation: WMJ. 2003;102(3):35-40
references.pmid: 12822288
references.citation: Int J Gynaecol Obstet. 1997 Oct;59(1):25-9
references.pmid: 9359442
references.citation: BMJ. 1990 Mar 10;300(6725):638-40
references.pmid: 2322699
references.citation: Obstet Gynecol. 2009 Dec;114(6):1409-1420
references.pmid: 20134296
references.citation: Nat Clin Pract Oncol. 2005 Feb;2(2):90-7; quiz 1 p following 113
references.pmid: 16264881
references.citation: Acta Cytol. 1990 Mar-Apr;34(2):133-5
references.pmid: 2321444
references.citation: JAMA. 1985 Feb 15;253(7):989-96
references.pmid: 3968836