Randomly Selected Smear Test Screening Outcome

Randomly Selected Smear Test Screening Outcome

Author(s)

Bessy Varghese, Abida Qureshi, Nawal Dayoub

Abstract

Background:

 The cervical cancer screening coverage in Bahrain was 43.1% in 2018. Even with  the presence of a screening program, most screening in the Middle East usually take place at  random.

Objective:

To evaluate the risk factors and outcome of randomly selected smear tests.

Design:

A Retrospective Study.

Setting:

 Bahrain Defence Force Hospital, Bahrain.

Method:

All Pap smear tests performed from January 2017 to December 2017 were included in the study. The smear results were divided into four groups: normal, borderline, premalignant changes and malignant changes. Risk factors such as age, parity, contraceptive/medical history, smoking, and human papillomavirus (HPV) positive screening were documented. The outcome of care was divided into four categories: repeat smear test, colposcopy and cervical biopsy, hysteroscopy/ dilatation and curettage, and hysterectomy.

Result:

A total of 2,626 smear tests were included in the study; 2,246 (85.5%) were negative smears. Two hundred forty (9%) were borderline and 135 (5%) had pre-cancerous lesions. Five (0.2%) cases were malignant; the older the patient, the higher the risk of malignant changes.  Twenty-nine (1.1%) of the previous pre-cancerous smear became negative on the successive smear and 72 (2.7%) patients had repeat smear test. Some of the negative and borderline patients had a hysterectomy.

Conclusion:

A uniform cervical screening policy must be initiated and cost-effective clear protocols must be laid down to improve the quality of women’s health in Bahrain.

Bahrain Medical Bulletin

Bahrain Med Bull 2020; 42 (1): 31 - 34

Available on (https://www.bahrainmedicalbulletin.com/MARCH2020/MAR2020_SMEAR.pdf)