Cervical Cytology in Postmenopausal Women of Lucknow Rural Areas, India

Introduction: As carcinoma cervix mostly occurs after the age of 50 in women, it is mandatory to cytologically examine all the postmenopausal women above 45 to detect the onset of any premalignant changes in the cervix. The present study was conducted on 537 postmenopausal women living in rural areas and the collected data were analyzed in terms of predisposing factors of cervical carcinogenesis. Methods: The 537 postmenopausal women were selected from the 183 rural camps organized during cervical cancer screening in the villages of Lucknow from May 2013 to December 2019. Results: Though the frequency of atypical squamous cell changes of unknown significance (ASCUS) was very low (2.4%) in the postmenopausal women, but of squamous intraepithelial lesions of cervix (SIL) was very high (15.6%). A rise was observed in the SIL rate with increasing duration of menopause up to the age of 60 after which it declined. Candida albicans infection was the most common sexually transmitted disease (STD) and was mostly observed during the early menopausal years of 45-50 years. Different cervical lesions and gynecological symptoms were also observed mostly in the early menopause years. The SIL rate was higher with cervical lesions and postmenopausal bleeding (29.6%). The parity showed a reverse trend in postmenopausal women compared with perimenopausal ones, being higher in the nulliparous women and declining with increased parity. Conclusion: The SIL rate was high in postmenopausal women living in the rural areas which increased with increasing duration of menopause up to the age of 60. The Pap smear screening is, therefore, mandatory in older women to exclude any premalignancy.