Role of pap smear as an effective secreening tool?

It's usage or effectiveness in rural or urban areas of pakistan?

Pap smear is a method of cervical screening used to detect potentially pre-cancerous and
cancerous processes in the cervix.

Abnormal findings are often followed up by more sensitive diagnostic procedures, and, if
required, interventions that aim to prevent progression to cervical cancer.

According to NHS and WHO it's an effective method and should be Implimented in all countries.

It reduces the incidence of cervical carcinoma by 50% and reduces the mortality by 7%.

Advantages of pap smear is that:

Its highly sensitive (72%) and specific (90-94%)

Easy to perform.

Cost effective.

Acceptable by general population.

Can be done in opd.

In case of abnormal results definetive treatement is avaliable.

Disadvantages is:

Trained personal required.

Proper technique to take sample.

Transportation of sample.

Record should be kept.

Followup should be maintained.

Inter and intra observer variation in the reports can lead to wrong findings.

It can't be used to secreen cervical adenocarcinoma.

In Developing countries like pakistan with poor health resources it's an excellent secreening
test should be provided to all woman....secreening schedule of RCOG and NHS should be
followed.....

Secreening started in sexually active women at 25 year

25-49 : 3 years secreening.

50-65: 4 years secreening.

In urban countries where facilities of HPV it can be combined with that....

In order to make it effective.....General education of women through media in hosp or in family

planning clinics along with training of doctors to obtain proper samples,keep proper record and
councel the women in all languages regarding secreening and to maintain followup.

Training of pathologist to proper interpretation of sample will reduce the false results.

In urban areas where feasible cytopathologist can be replaced by automatic computarized

machine to detect report....this will reduce false results.

In urban areas conventional pap smear can be replaced by liquid based cytology with better
sensitivity and reduce false results.

In rural areas every women should be educated and cervical secreening should be Implimented
but if not possible atleast visual inspection of cervix with acetic acid and iodine should be
done...in case of suspicion referral to district health service or tertiary care center will help to
reduce incidence of cervical carcinoma

Amna Saeed Asim Khan Sonia Zulfqar Gynae Obs Nadia Kanval Shafiq Ahmad Aruna Qandeela
and everyone else do add if u wana add.....