Atypical cells in Pap Smears, an evaluation of proportions and possible risk factors at the Jos University Teaching Hospital, Nigeria.
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Pap smear, atypical cells, Bethesda, Jos University Teaching Hospital.
Abstract
Background: Atypical cells of the epithelium of the cervix are precursors of cervical cancer which is a leading cause of morbidity and mortality in our environment.
Aim: To determine proportion of atypical cells with their associated risk factors in our low resource setting.
Methods: This was a cross sectional study conducted among patients that presented for pap smear screening at the Jos University Teaching Hospital, Jos, North Central Nigeria over a three-year period ( January, 2015-December , 2017).
Materials: Pap smears results of eligible patients and demographic/clinical variables such as age, age at first sexual intercourse, parity, history of cigarette smoking, HIV status, and history of sexually transmitted infections were collated and analyzed.
Results: Of the 4,478 Pap smear samples analyzed during the three-year (2015- 2017) period, 96 samples had atypical changes constituting only 2.14%. The mean age was 39.51 years (SD 10.97). Low grade lesions (ASC-US, AGUS) were the commonest accounting for 72(75.00%) while high grade lesions (ASC-H, AGUS favor neoplastic) were only 24(25.00%). ASC-US was the commonest 65(65.66%) atypical lesion and AGUS, favor neoplastic was the least common lesion 3(3.03%). Only 2(2.08%) of these patients had history of sexually transmitted infections and 3(3.13%) of them were HIV positive. Association between Atypical Pap smears lesions and some sociodemographic variables was not statistically significant.
Conclusion: Atypical cervical lesions remains an important pathology in our low-resource setting requiring institutionalization of algorithm/triage for its management.
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