Citation Information :
Kharkwal KC, Lo K, Tahmina A, Daniel TL, Teelashinee N, Hing TC, Fazali NB. A Study on Effectiveness of Pap Smear in Mass Screening of Premalignant Lesions of Cervix. 2019; 2 (2):65-68.
Background and objectives: A study on the accuracy of Pap smear was conducted in Pantai Hospital, Sungai Petani, Malaysia involving 125 patients from the Department of Obstetrics and Gynaecology. Cervical cancer is a significant health issue for women; being the second most common cancer among women in Malaysia hence early detection of precancerous lesions can prevent progression to cervical carcinoma. The objective of this study was to measure the sensitivity, specificity, positive predictive value, negative predictive value, percentage of false-negative, percentage of false-positive and yield of Pap smear by comparing Pap smear results with colposcopy guided cervical biopsy. Materials and methods: The study was conducted among 125 patients who have undergone both Pap smear and colposcopy-guided cervical biopsy using a cross-sectional study with a purposive sampling method. The data obtained were analyzed statistically. Results: 125 patients participated in this study, giving Pap smear a sensitivity of 38%, specificity of 64%, positive predictive value of 80.85%, negative predictive value of 20.51%, false-positive for intraepithelial lesion or malignancy of 38%, false-negative for intraepithelial lesion or malignancy 62%. Of the total 125 patients studied, 62.4% were indicated to have a cervical biopsy due to clinical suspicion and among them biopsy report was positive for intraepithelial lesion or malignancy in 79.5%. Conclusion: The sensitivity and specificity of Pap smear as a screening tool for precancerous cervical lesions is low. It is therefore inadequate to be used alone as a screening tool. The study also shows that having a high index of clinical suspicion even when the Pap smear results were normal was important in order not to miss a precancerous cervical lesion as early detection can prevent progression to cervical cancer. Hence, a more experienced doctor with a high index of clinical suspicion is vital.
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