Pattern of cervical smear abnormalities using the revised Bethesda system in a tertiary care hospital in Western Saudi Arabia.
OBJECTIVE
To evaluate Pap smear (PS) diagnoses at a tertiary care hospital using the revised Bethesda system, and to compare the results with other similar studies.


METHODS
We designed a retrospective study to review all PS from the Cytopathology Department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from January 2005 to December 2009.


RESULTS
Of the 7297 cases reviewed, 1254 cases (17.3%) had epithelial cell abnormalities. The categories included: atypical squamous cell of undetermined significance (ASC-US) found in 9.3%, atypical squamous cell, cannot exclude high squamous intraepithelial lesion (ASC-H) in 0.8%, low grade squamous intraepithelial lesion (LSIL) in 2.7%, and high grade squamous cell lesion (HSIL) in 0.9%. The mean age incidence (MAI) was 40 years for ASC-US, 42 years for ASC-H, 47 years for LSIL, and 45 years for MAI. Squamous cell carcinoma (SCC) was found in 0.06% with mean age incidence of 46 years. In the atypical glandular cell category, there was 3.2% atypical glandular cell of undetermined clinical significance not otherwise specified, 0.1% atypical glandular cells favoring neoplasm, and 0.08% atypical endometrial cells favoring neoplasm.


CONCLUSIONS
The incidence of abnormal PS has increased from previously 4.7%, to 17.3% in the present study. The ASC-US among total PS examined has also significantly increased. The increase in the number of positive PS raises concerns of whether the new BS results are an artificial increase in the prevalence and the predictive value of cytology to some extent.
Department of Anatomic Pathology, Faculty of Medicine, King Abdulaziz University Hospital, PO Box 51241, Jeddah 21543, Kingdom of Saudi Arabia. fjaltaf@yahoo.com
Fadwa J
FJ
Altaf
Shagufta T
ST
Mufti
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D002471:Cell Transformation, Neoplastic; D055088:Early Detection of Cancer; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000473:pathology; D065006:Papanicolaou Test / Q000379:methods; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012680:Sensitivity and Specificity; D063128:Tertiary Health Care; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D014626:Vaginal Smears / Q000706:statistics & numerical data; D002578:Uterine Cervical Dysplasia / Q000473:pathology