WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Intisar Salim Pity*, Abeer Ibrahim

ABSTRACT

Background: Cervical smear (also known as Pap smear or Pap test) is a well-known test that saves many women’s lives because it helps detect cervical cancerous and precancerous lesions. The objective of this study is to determine the frequency of various cytological abnormalities in women advised to do this test in Duhok Province during 11- year-period (2012 to March 202) since the test was launched. Second, in the same group of women, evaluate the age-specific cytological anomalies. Method: A cross-sectional study of 8000 cases from patients visiting Duhok Central Laboratories was conducted from February 2012 to March 2023, while case analysis was achieved within 7-month-period (June 2023 to February 2024). The Pap test performed included liquid-based cytology samples collected by pathologists, gynecologists and well-trained technicians on women visiting hospitals for various complaints. Data, including age groups and pathological diagnoses, were extracted from electronic patient files and analyzed following ethical approval from the Human Research Ethics Committee at Duhok University/College of Medicine. Results: In the studied samples, 95.2% were diagnosed as Negative for Intraepithelial Lesions or malignancy (NILM) with the highest rate (98.3%) in patients aged ≤20 years and the lowest (92.5%) in those aged 51-60 years. Atypical Squamous cells of Undetermined Significance (ASCUS) was found in 4%, with the highest rate (5.5%) in patients aged 51-60 years. Other diagnoses such as Atypical Squamous cells, High Squamous intraepithelial Lesion cannot be excluded (ASC-H), Atypical Glandular cells of Undetermined Significance AGUS), Low Squamous intraepithelial Lesion (LSIL), High Squamous intraepithelial Lesion (HSIL), invasive Squamous Cell Carcinoma (SCC), and adenocarcinoma were rare, with rates below 0.3% and no significant differences between age groups except for AGUS (p = 0.001) and adenocarcinoma (p = 0.032). Conclusion: The distribution of cervical cytological abnormalities in the study matches previous researches performed in the same locality and elsewhere in the world. Cytologically, yielding precancerous and cancerous cases among different age groups especially young women in this study worthens application of Pap smear screening program in this locality and necessitates testing and vaccination for HPV infection among young women to prevent, detect and early treat HPV-related cervical epithelial abnormalities.