title: Do health care providers have a lower prevalence of abnormal pap smears than the general public?
abstract: BACKGROUND
  Most Thai people believe that health care providers have a lower risk of any disease than their patients. This belief may lull Thai health care providers into accepting the false belief that they are at a lower risk of having the precancerous conditions that lead to cervical cancer.
  
  
  OBJECTIVE
  This study compares the prevalence of abnormal Pap smears from health care providers (HC) and non health care providers (NHC) by using the standard liquid-based Pap smear processing at Thammasat University Hospital's pathology department, Thailand.
  
  
  METHODS
  Both health care providers (HC) and non health care providers (NHC) were patients at the outpatient clinic, Thammasat University Hospital. They were screened for cervical cancer by using liquid-based Pap smear (LBP). Cytological diagnoses and specimen adequacy were classified using the Bethesda system 2001. All subjects who had abnormal cytology more than atypical squamous cells or atypical glandular cells were counseled to have performed a colposcopic directed biopsy for confirmation of pathology.
  
  
  METHODS
  A total of 250 liquid-base Pap smears were processed and evaluated at the Gynecology clinic, Thammasat University Hospital from April 2008 to May 2008.
  
  
  RESULTS
  The groups of HC and NHC consisted of 122 and 128 women, respectively. In general, both the HC and NHC groups were similar in their age, religion, income and education level distributions. The range of ages was between 16 and 75 years, with the mean age equal to 40.2 +/- 10.5 years. Prevalence of abnormal Pap smears was 9.8% in HC and 9.4% in NHC (p-value = 0.90). HC showed atypical change (ASC, AGC), low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) at 0.8%, 1.6% and 7.4%, respectively. NHC had an incidence of atypical change, LSIL and HSIL at 0.8%, 0.8% and 7.8%. HC had an equal incidence of abnormal Pap smears prevalence to NHC. Further, the percentage of HC and NHC groups with histological confirmed cervical intraepithelial neoplasia (CIN) 1 were not significantly different (4.92% vs. 6.25%, p-value = 0.70), likewise CIN 2/3 (1.64% vs. 1.56%, p-value = 1.00). According to our study the rate of abnormal Pap smears observed in both health care providers and clients was essentially the same.
  
  
  CONCLUSIONS
  The prevalence of abnormal Pap smears in health care providers was statistically equivalent to that in their clients.
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. k_suwannarurk@yahoo.com
authors.forename: Komsun
authors.initials: K
authors.lastname: Suwannarurk
authors.forename: Konkarn
authors.initials: K
authors.lastname: Bhamarapravatana
authors.forename: Pakpoom
authors.initials: P
authors.lastname: Kheolamai
authors.forename: Yuttadej
authors.initials: Y
authors.lastname: Thaweekul
authors.forename: Karicha
authors.initials: K
authors.lastname: Mairaing
authors.forename: Yenrudee
authors.initials: Y
authors.lastname: Poomtavorn
authors.forename: Junya
authors.initials: J
authors.lastname: Pattaraarchachai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D012959:Socioeconomic Factors; D013785:Thailand / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology