Diagnostic Value of Conventional Cytology in Detecting Human Papillomavirus in Cervical Smears

Abstract

Background: For a country like Nigeria where conventional Pap smear is still the mainstay of screening for preneoplastic lesions of cervical cancer there is need to determine the diagnostic value of this technique for detecting HPV, the most important aetiological agent of this cancer. Materials and Methods: 300 women were subjected to conventional Pap smear with simultaneous sampling for E6 gene of HPV 16 and 18 by PCR, and the sensitivity, specificity and positive predictive value of Pap smear for detecting HPV infection (Low Grade Intraepithelial Lesions) determined. Results: Conventional Pap smear showed a sensitivity of 34.3%, specificity of 99.3% and positive predictive value of 85.7% (p<0.05). Conclusion: This study concludes that there is need for adoption of more sensitive methods such as liquid-based cytology and HPV testing for detecting early changes such as HPV infection in cervical epithelium in view of the low sensitivity of conventional Pap smear. This will help in better triaging of patients for follow-up.