Cervical cancer screening using liquid-based cytology (LBC) in a secondary care hospital in Northeast India

Abstract

According to the latest National Cancer Registry Programme (NCRP 2020) report, India had the highest incidence rate of cervical cancer (27.7 per 100,000) in Asia and also cervix uteri was the leading anatomical site of cancer in women population of Nagaland (16.4%). Lack of access to healthcare and awareness has led to the increased cases of cervical cancer, in particularly the resource-limited areas. A retrospective study involving 711 samples of cervical smears of women collected in the Department of Gynaecology were analysed between May 2019-May 2021 at CIHSR hospital. The objective of this study was to address this preventable cancer burden and also to determine a fraction of pap cervical smear finding through LBC in a secondary level hospital in Dimapur, Nagaland. 711 Pap smears using LBC technique were processed in the Department of Pathology of which 20 samples (2.81%) yielded unsatisfactory result or were rejected. Of the remaining 691 samples, 16.35% (113/691) had abnormal results. The Bethesda System (TBS-2014) for cervical cancer screening was used for classifying the categories, of which ASC-US was 48.67% (55/113), LSIL 7.96% (9/113), ASC-H 22.12% (25/113), High grade squamous intraepithelial lesion (HSIL) 17.69% (20/113), Squamous cell carcinoma 2.65% (3/113) and adenocarcinoma 0.88% (1/113). The chief complaints among women with abnormal cytology were pain in the lower abdomen (27.4%), white discharge per vaginum (22.1%) and bleeding per vaginum (15.0%). This study determines the first retrospective analysis of Pap smear finding through LBC in the state and highlights the deficiency of effective screening programme and testing facilities.