Histopathological Patterns and Characteristics of Abnormal Cervical Smear in Madinah Region of Saudi Arabia

Abstract

Cervical cancer is a major public health problem that continues to be one of the leading female genital cancers<br />worldwide. In the kingdom of Saudi Arabia (KSA), cervical cancer ranks the fifteenth most frequent cancer among<br />females. This study is the first published research study addressing the screening of cervical cancer in Madinah region<br />of KSA. Aim: To evaluate the abnormal cytological entities detected by cervical Pap smear in Madinah region of KSA<br />and to compare the results with other national and international studies. Methods: This retrospective case-control study<br />was conducted in the Departments of Obstetrics and Gynecology, and Histopathology at the Maternity and Children<br />Hospital (MCH), Madinah, KSA from January 2013 to December 2015. Results: Of the 1594 cases reviewed, only<br />38 cases (2.4%) had epithelial cell abnormalities. High grade squamous intraepithelial lesions (HSIL) and low grade<br />squamous intraepithelial lesions (LSIL) were the most common diagnosis categories, and cervical cancer accounted<br />for 36.8% of the total cases for each, followed by atypical squamous cells of uncertain significance (ASCUS) found<br />in (15.9%). Squamous cell carcinoma (SCC ) was found in (5.3%) of the cases. Patients with abnormal epithelial<br />changes had higher parity (P=0.021) and presented more with a complaint of postcoital bleeding (P<0.0001), tend to<br />have abnormal cervical appearance (P=0.004), more likely bleeding on touch (P=0.001) and associated with cervical<br />erosion (P=0.014). Conclusion: The study showed a relatively low prevalence of epithelial cell lesions. These lesions<br />were mainly squamous cell lesions harbored by females who have an abnormal cervical appearance, and those with<br />high parity who were lacking cervical screening program.