Colposcopic evaluation of cervix with persistent inflammatory Pap smear: A prospective analytical study.
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.
Dasari
Papa
P
Department of OBGY, JIPMER, Puducherry, India.
Rajathi
S
S
Kumar
Surendra V
SV
Gynecol Oncol. 2007 Apr;105(1):157-65
17229459
J Fam Pract. 1994 Jan;38(1):40-4
8289050
Acta Cytol. 1998 Nov-Dec;42(6):1481
9850666
Obstet Gynecol. 2003 Aug;102(2):417-27
12907124
Acta Cytol. 1994 Jul-Aug;38(4):531-6
8042417
WMJ. 2003;102(3):35-40
12822288
Int J Gynaecol Obstet. 1997 Oct;59(1):25-9
9359442
BMJ. 1990 Mar 10;300(6725):638-40
2322699
Obstet Gynecol. 2009 Dec;114(6):1409-1420
20134296
Nat Clin Pract Oncol. 2005 Feb;2(2):90-7; quiz 1 p following 113
16264881
Acta Cytol. 1990 Mar-Apr;34(2):133-5
2321444
JAMA. 1985 Feb 15;253(7):989-96
3968836