'Pap smear' for screening of precancerous conditions of cervix.

Cervical intra-epithelial neoplasia (cin) and cervical cancer remain important health problems for women worldwide. it is largely a preventable disease that is characterised by a long lead time. the objective of this study was to determine the frequency of precancerous conditions of cervix (cin i-iii) in women with chronic vaginal discharge by pap smear screening. the study was conducted at the outpatient department of obstetric and gynaecology,nishtar hospital multan,and multan institute of nuclear medicine & radiotherapy (minar) from february 2009 to february 2010. two hundred and eighty patients with complaint of chronic vaginal discharge were selected. their detailed history was documented on a proforma,pap smear taken at minar,and samples sent to pathology department of nishtar hospital multan for cytological examination. all mild dyskaryosis or cin i cases were advised follow-up with repeat pap smear in 6-12 months and those with moderate to severe neoplasia (cin ii-iii) were further investigated by cervical biopsy and managed accordingly. of the total,100 patients were between 25-30 years of age,and 180 between 31-35 years of age. mean age of patients was 31.6 years,mean age at marriage 21.7 years,and mean parity was 3.6. most of the patients (67.9%) belonged to low socioeconomic status. the cytological examination of the smears showed no changes (normal) in 100 (35.7%) cases,while 156 (55.7%) cases showed inflammatory changes,10 (3.6%) showed dysplastic changes,of whom 8 cases had cin-i (2.8%) and one case was of cin-ii (0.4%). one was having cin-iii/severe dysplasia (0.4%). inadequate sample was reported in 14 (5%) cases. pap smear should be used as a routine test for all sexually active,young females presented to the gynaecology outpatient department,for early detection of cervical pre cancer (cin) as it is not uncommon in our set up.