Papanicolaou smear as a tool for detection of Cervico-vaginal Infections in a Rural Tertiary care centre of Northern India: Retrospective analysis

Background: The Papanicolaou test (Pap test) is most sensitive and widely used screening test for early diagnosis of various cervical lesions including infections. Objectives: To know the utility of Pap smears in diagnosing cervical infections and to study the pattern of infections on Pap smears occurring in this region of India. Material and Methods: Retrospective analysis of Pap smear reports of 5725 women who attended the Out Patient Department of Obstetrics and Gynecology with various complaints and for routine Pap smear screening during the period of January 2010 to December 2015 were collected from the Pathology Department of a rural tertiary care centre of Northern India after proper Institutional Ethical approval. The reporting of Pap smears was done by Bethesda 2001 system and by wet mount preparation of slides for diagnosis of various infections. Final analysis of data was done by using SPSS-20 version software. Results: Of 5725 Pap smears examined retrospectively, 4448 (77.69%) cases were benign epithelial patterns, 580 (10.13%) abnormal epithelial patterns and remaining 697 (12.17%) were unsatisfactory. Of 4448 benign cases, 1292 had infectious patterns on Pap smear with bacterial vaginosis (68.73%) being most common followed by Trichomoniasis (20.05%) and candidiasis (11.07%). HPV infection was noted in only 2 cases (0.15%). Majority of women belonged to 41-50 years of age group. Conclusion: Pap smear is one of the most simple and quick test for diagnosing cervical infections. However, for confirmation of Pap smear reports for infections, other tests like vaginal culture are required.