Pap smear screening for a sample of female patients with anogenital
Background and objective: Genital human papillomavirus (HPV) infection is closely linked to cancer of the cervix. The Papanicolaou-stained smear is the primary method for detection of high-risk HPV. This study aimed to identify women at risk of developing cervical precancerous lesions.
Methods: This cross-sectional study involved 75 married, non-pregnant women with anogenital warts. Sociodemographic, fertility history, and details of the anogenital wart infection were obtained from all patients through a questionnaire. Pap smear was performed for all patients, and histopathological assessment was done.
Results: The age of the patients ranged from 18 to 55 years. The mean (± SD) age of marriage was 22.2 (± 5.77) years, 12 (16%) women gave birth to a child before the age of 18 years. Filiform warts were identified in 33 (44%) patients, while the acuminate type was found in 24 (32%) patients. Flat warts were seen in nine (12%) patients. There was a significant association between the type of wart and recurrence. Severe erosive cervicitis was found in 45 (60%) smears. Moderate cervicitis was observed in 24 (32%) smears, and six (8%) had mild cervicitis. A significant association was found between duration of the genital wart and cervicitis. Twenty percent had atypical squamous cells of undetermined significance. No malignant changes and no koilocytes were identified.
Conclusion: Early marriage, unawareness of the risk of anogenital warts, and neglecting regular Pap smears are risk factors for developing cervical cancer.
James WD, Berger TG, Elaston DM, Neuhaus IM. Viral Diseases. In: Andrews’ Diseases of the Skin, Clinical Dermatology. 12thed. Philadelphia: Elsevier; 2016. P. 403.
Murray PR, Rosenthal KS, Pfaller MA. Papillomaviruses and Polyomaviruses. In: Medical Microbiology. 8th ed. Philadelphia: Elsevier; 2016. P. 408–17.
Habif TP. Sexually Transmitted Viral Infections. In: Clinical Dermatology, A color guide to diagnosis and therapy; 6thed. Elsevier; 2016. P. 418.
Androphy EJ, Kirnbauer R. Human Papilloma Virus Infections. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine; 8thed. New York: McGraw-Hill; 2012. P. 2431.
Weller R, Hunter H, Mann M. Infections. In: Clinical Dermatology. 5th ed. USA: Wiley Blackwell; 2015. P. 230.
Shafi MI. Premalignant and Malignant Disease of the Cervix. In: Edmonds DK. Dewhurst’s Textbook of Obstetrics & Gynecology. 8th ed. Wiley Blackwell; 2012. P. 747–58.
Cibas E S. Cervical and Vaginal Cytology. Cibas ES, Ducatman B S. Cytology Diagnostic Principles and Clinical Correlates. 4th ed. Philadelphia: Elsevier; 2014. P. 1–53.
Sterling J C. Viral Infections. In: Griffiths CEM, Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rook’s Textbook of Dermatology. 9th ed. Oxford: Black-Well Scientific Publication; 2016. P. 25–55.
Solomon D, Davey D, Kurman R, Moriarty A, Connor D O, Prey M. The Forum Group Members & the Bethesda 2001 Workshop. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA 2002; 287:2114–9.
WHO Fact Sheet 380: Human papillomavirus (HPV) and cervical cancer. Geneva: World Health Organization; 2016.
Soori T, Hallaji Z, Noroozi-Nejad E. Genital warts in 250 Iranian patients and their high- risk sexual behaviors. Arch Iran Med 2013; 16(9):518–20.
Akcali S, Goker A, Ecemis T, Kandiloglu AR, Sanlidag T. Human papilloma virus frequency and genotype distribution in a Turkish population. Asian Pacific J Cancer Prev 2013; 14(1):503–6.
Fleischer AB, Parrish CA, Glenn R, Feldman SR. Condylomata acuminata (genital warts): Patient demographics and treating physicians. Sex Transm Dis 2001; 28(11):643–7.
Brooks GF, Morse SA, Carroll KC, Mietzner TA, Butel JS. Virology: General Properties of Viruses. In: Jawetz, Melnick, & Adelberg’s Medical Microbiology.26thed. New York. McGraw-Hill; 2013. P. 646–7.
Lynch PJ, Margesson LJ. Skin-Colored and Red Papules and Nodules. In: Black M, Rudolph CM, Edwards L, Lynch PJ. Obstetric and Gynecologic Dermatology. 3rd ed. London. Elsevier; 2008. P. 199.
Mehmetoglu H C, Sadikoglu G, Ozcakir A, BilgelN.Pap smear screening in the primary health care setting: A study from Turkey. N Am J Med Sci 2010; 2(10):467–72.
Sangrajrang S, Laowahutanont P, Wongsena M, Muwonge R, Karalak A, Imsamran W, et al. Comparative accuracy of Pap smear and HPV screening in Ubon Ratchathani in Thailand. Papillomavirus Research 2017; (3):30–5.
Nieminen P, Kallio M, Anttila A, Hakama M. Organized versus spontaneous pap-smear screening for cervical cancer: A case-control study. Int J Cancer 1999; 38(1):55–8.
Tamera E, Cakmaka S K, Ilhan MN, Artüz F. Demographic characteristics and risk factors in Turkish patients with anogenital warts. J Infect Public Health 2016; 9:661–6.
Rahman T, Tabassum S, Jahan M. Risk of cervical cancer associated with HPV infection among the gynae outdoor patients. Bang Med J Khulna 2013; 46: 3-6.
Schiffman M, Castle PE. Human papillomavirus: epidemiology and public health. Arch Pathol Lab Med 2003; 127:930–4.
Manhart LE, Koutsky LA. Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis. Sex Transm Dis 2002; 29(11):725–35.
Adam E, Berkova Z, Daxnerova Z, Icenogle J, Reeves WC, Kaufman RH. Papillomavirus detection: Demographic and behavioral characteristics influencing the identification of cervical disease. Am J Obstet Gynecol 2002; 182(2):257–64.
Dutta DC, Konar H. Infections of the individual pelvic organs. In: DC DUTTA's textbook of gynecology. 6thed. London: Jaypee Brothers Medical Publisher; 2013. P.167.
Mehta V, Vasanth V, Balachandran C. Pap smear. Indian J Dermatol Venereol Leprol 2009; 75(2):214–6.
Patel MM, Pandya AN, Modi J. Cervical Pap smear study and its utility in cancer screening, to specify the strategy for cervical cancer control. National Journal of Community Medicine 2011; 2(1):49–51.
Monga A, Dobbs S. Premalignant and malignant disease of the cervix. In: Gynecology by ten teachers.19th ed. London: Taylor & Francis Group; 2011. P. 125–33.
Thomison J, Thomas LK, Shroyer KR. Human papillomavirus: molecular and cytologic/histologic aspects related to cervical intraepithelial neoplasia and carcinoma. Human Pathology 2008; 39:154–66.
Denny L, Quinn M, Sankaranarayanan R. Screening for cervical cancer in developing countries. Vaccine 2006; 24(S3):71–7.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).