Diagnosing pre-invasive cervical lesions – experience with pap smear in a Nigerian teaching hospital

Abstract

Pap smear is a tested screening method for detection of pre-invasive cervical lesions, and effective Pap screening has reduced the burden of cervical cancer in developed countries. The aim of this study is to highlight various indications for Pap smear and the prevalence of cytological abnormalities in Ilorin, Nigeria using the Bethesda system. This is a prospective study that was carried in the University of Ilorin Teaching Hospital between June 2011 and May 2013. A total 566 smears were reported and a mean age 43±10 years fell short of acceptable internationally recommended age of 18 years to commence Pap screening. The relative frequencies of indications for Pap smears include   routine screening (58.1%), vaginal discharge (20.3%), postcoital bleeding (12.0%) and postmenopausal bleeding 43 (7.6%). Of the total smears reported, epithelial abnormalities seen include low grade SIL 30 (5.3%) and high grade SIL 9 (1.6%) respectively. Majority of the smear-positive cases were seen in women who came for routine screening and the prevalence of intraepithelial lesions reported from our study is higher than what have been documented from other parts of the world. Increased public awareness about Pap smear, a properly organized screening program and availability of treatment modality for screen-positive women will reduce the burden of cervical cancer in Nigeria.

Keywords: Pap smear, screening, cervical cancer