Patterns and Frequency of Abnormal Cervical Cytology Findings during Pap Test Screening in a Private Hospital in Bangladesh

Open Access

Abstract

Background: Cervical cancer remains a leading preventable malignancy among women in developing countries, where screening coverage and timely follow-up are often limited. Pap smear cytology, reported using the Bethesda System, is a practical screening tool in routine clinical settings, yet contemporary data on the pattern and frequency of abnormal cervical cytology in private hospital-based screening services in Bangladesh are limited. Methods & Materials: This cross-sectional descriptive study was conducted in the Gynecology and Obstetrics Outpatient Department at Khalishpur Clinic, Khulna, Bangladesh, including 112 consenting women attending for routine or symptomatic evaluation or cervical cancer screening from January, 2024 to December, 2024. Women with prior hysterectomy, known cervical malignancy, active heavy bleeding, or refusal of consent were excluded. Results: Among 112 women screened, most were aged 26-35 years (50.0%), with a mean age of 37±11.5 years; mean age at marriage was 19±12.6 years. Most had parity 1-3 (75.0%), 55.4% reported no contraceptive use, and 73.2% had regular menstruation. Discharge-related symptoms predominated, particularly leucorrhea (59.8%) and foul-smelling discharge (42.9%); on examination, cervical lesions were noted in 12.5%, lower abdominal pain in 16.1%, and uterine prolapse in 5.4%. Cytology was NILM at 80.4%, ASC-US (17.0%) with rare HSIL (1.8%). In multivariable analysis, age was not associated with abnormal cytology, whereas age at marriage showed a significant positive association (OR 1.176, p=0.027); leucorrhea and uterine prolapse showed suggestive but non-significant increased odds with wide confidence intervals. Conclusion: Most Pap smears were NILM, with abnormalities mainly ASC-US and rare HSIL. Strengthening standardized triage, follow-up, and documentation, with HPV-based testing where feasible, is essential to maximize the impact of opportunistic screening in this setting.