• Ahmad Ahsan Khan
  • Shazia Nayyar
Keywords: Papanicolaou smear, cervical, intraepithelial neoplasia, cervical cancer


Background: Cervical cancer related morbidity and mortality among women are major health problems in developing countries. Premalignant lesion of the cervix, i.e., intraepithelial neoplasia precedes cervical cancer and can be detected by Pap smear test. This study aimed to determine the prevalence of premalignant lesion of cervix in District Quetta. Methods: This study was based on 100 cases from the Outpatient Department of Obstetrics and Gynaecology at Combined Military Hospital Quetta. The selection criterion was sexually active patients presenting with complaints of vaginal discharge, dyspareunia, menorrhagia and lower abdominal pain. Patients less than 20 years of age, known cases of intraepithelial or invasive malignancy, and natives outside District Quetta were excluded. After fixation and staining, each smear was carefully examined according to criteria laid down by The Bethesda System for reporting cervical cytology. Results: Mean age of the patients was 47 years. The presenting complaints in descending order of frequency included lower abdominal pain 39%, vaginal discharge 29%, menorrhagia 28% and post coital bleeding in 4%. Out of 100 cases, 17 (17%) cases were positive for premalignant lesions and 79 (79%) were negative, whereas 4 (4%) were inadequate for analysis. Conclusion: Pre-malignant lesions of the cervix are common in District Quetta and can be diagnosed early by Pap smears.


1. Duenas-Gonzalez A, Serrano-Olvera A, Cetina L. New molecular targets against cervical cancer. Int J Women’s Health 2014;6:1023–31.
2. Cervical cancer estimated incidence, mortality and prevalence worldwide in 2012. GLOBOCAN; WHO. 2012. Available at:
3. Karjane N, Chelmow D. New cervical cancer screening guidelines, again. Obstet Gynecol Clin North Am 2013;40(2):211–23.
4. Andrae B, Andersson TM, Lambert PC, Kemetli L, Silfverdal L, Strander B, et al. Screening and cervical cancer cure: population based cohort study. BMJ 2012;344:e900.
5. Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002: Cancer incidence, mortality and prevalence worldwide. (Technical Report) Vol. 5 Ver. 2. Lyon, France: International Agency for Research on Cancer; 2004.p. 1741–52.
6. Badar F, Anwar N, Meerza F, Sultan F. Cervical carcinoma in a Muslim community. Asian Pac J Cancer Prev 2007;8(1):24–6.
7. Joshi C, Kujur P, Thakur N. Correlation of Pap smear and colposcopy in relation to histopathological findings in detection of premalignant lesions of cervix in a tertiary care centre. Int J Sci Study 2015;3:55–60.
8. Naik R, Minj AM, Panda R, Satpathi S, Behera PK, Panda KM. Cytohistological correlation and accuracy of the pap smear test in diagnosis of cervical lesions: a hospital based cross-sectional study from Odisha, India. Med Sci 2015;3:242–9 .
9. Tarney CM, Han J. Postcoital bleeding: a review on etiology, diagnosis, and management. Obstet Gynecol Int 2014;2014:192087.
10. Ashmita D, Shakuntala PN, Rao SR, Sharma SK, Geethanjali S. Comparison and correlation of pap smear, coploscopy and histopathology in symptomatic women and suspicious looking cervix in a tertiary hospital care centre. Int J Health Sci Res 2013;3(5):50–9.
11. Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA: A Cancer J Clinicians 2012;62(3):147–72.
12. Everett T, Bryant A, Griffin MF, Martin-Hirsch PP, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev 2011;5:CD002834.
13. Bhalerao A, Kulkarni S, Ghike S, Kawthalkar A, Joshi S. Correlation of pap smear, colposcopy and histopathology in women with unhealthy cervix. J South Asian Feder Obstet Gynaecol 2012;4(2):97–8.
14. Bal MS, Goyal R, Suri AK, Mohi MK. Detection of abnormal cervical cytology in Papanicolaou smears. J Cytol 2012;29(1):45–7.
15. Haider G, Parveen Z, Anjum F, Munir A. Pap smear, an important screening tool to detect precancerous stage of carcinoma of cervix. J Ayub Med Coll Abbottabad 2013;25(1-2):26–7.
16. Noreen R, Qudussi H. Pap smear’ for screening of precancerous conditions of cervix. J Ayub Med Coll Abbottabad 2011;23(2):41–4.
17. Shobeiri, MJ, Halimi M, Dastranj M, Shahamphar J. Screening for cervical cancer and precancerous lesions in Tabriz. Med J Islamic Repub Iran 2007;21(1):1–10.
18. Khan MS, Raja FY, Ishfaq G, Tahir F, Subhan F, Kazi BM, et al. PAP smear screening for pre-cancerous conditions of the cervical cancer. Pak J Med Res 2005;44(3):111–3.
19. Krivak TH, Mc Broom J, Elkas J. Cervical and vaginal cancer. In: Berek J, (Ed). Novak’s Gynecology. 13th ed., Philadelphia: Lippincott, Williams & Wilkins; 2002.p. 1199–244.
20. Mehdizadeh A, Akbarian A, Magazeei T. Cervical cancer screening: Pap smear of 3000 women in south of Tehran. Ministry of Health, Treatment and Education 2002;23–5.
21. Allameh T. Cervical cancer screening: Pap smear of women in Isfahan. Ministry of Health, Treatment and Education 2002;23–5.
22. Thistle PJ, Chirenje ZM. Cervical cancer screening in a rural population of Zimbabwe. Cent Afr J Med 1997;43(9):246–51.


Download data is not yet available.
How to Cite
Khan AA, Nayyar S. FREQUENCY OF PREMALIGNANT LESIONS IN WOMEN SCREENED BY PAP SMEAR. PJP [Internet]. 20Aug.2018 [cited 16Jul.2019];14(3):14-6. Available from: