Strengths and Limitations of Pap Smear Screening: When Cytology Succeeds and Where it Fails
Background: Cervical cancer remains a significant global health concern, with early detection through Pap smear cytology playing a pivotal role in reducing morbidity and mortality. Objectives: This retrospective study evaluated the diagnostic accuracy of Pap smears in 2,746 cases, correlating cytolo...
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Light House Polyclinic Mangalore
2025-07-01
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| Series: | Online Journal of Health & Allied Sciences |
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| Online Access: | https://www.ojhas.org/issue94/2025-2-1.html |
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| author | Bhagyashree Rituraj Prabhat Pant Preeti Sharma |
| author_facet | Bhagyashree Rituraj Prabhat Pant Preeti Sharma |
| author_sort | Bhagyashree |
| collection | DOAJ |
| description | Background: Cervical cancer remains a significant global health concern, with early detection through Pap smear cytology playing a pivotal role in reducing morbidity and mortality. Objectives: This retrospective study evaluated the diagnostic accuracy of Pap smears in 2,746 cases, correlating cytological findings with histopathology in 158 cases. Methods: A retrospective analysis was conducted on 2,746 cervical cytology cases from year 2019 to 2024, categorized using the Bethesda System. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and chi-square tests were employed to assess cytology-histopathology concordance. Results: The study demonstrated high sensitivity (94.5%) and negative predictive value (90.3%), confirming the test’s reliability in ruling out disease. However, specificity was modest (50.9%), with frequent false positives in low-grade lesions (ASC-US: 55.6% discordance; AGC: 66.7% discordance), often due to benign mimics like cervicitis. High-grade lesions (HSIL, SCC, adenocarcinoma) showed perfect concordance (100%). Chi-square analysis revealed a significant association between cytology and histopathology (χ² = 87.42, p < 0.001), with subgroup analysis underscoring stronger correlations for high-grade lesions (HSIL/SCC: χ² = 42.36, p < 0.001). Conclusion: These findings highlight the Pap smear’s strength in detecting clinically significant lesions while emphasizing the need for adjunctive tests (e.g., HPV testing) to improve specificity in ambiguous cases. |
| format | Article |
| id | doaj-art-a7d9451cb19b4d9cbe77564f8a50e860 |
| institution | DOAJ |
| issn | 0972-5997 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Light House Polyclinic Mangalore |
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| series | Online Journal of Health & Allied Sciences |
| spelling | doaj-art-a7d9451cb19b4d9cbe77564f8a50e8602025-08-20T02:58:21ZengLight House Polyclinic MangaloreOnline Journal of Health & Allied Sciences0972-59972025-07-01242Strengths and Limitations of Pap Smear Screening: When Cytology Succeeds and Where it FailsBhagyashree0Rituraj1Prabhat Pant2Preeti Sharma3Assistant Professor, Dept. of Pathology, Government Medical College, Haldwani.Assistant Professor, Dept. of Pathology, Government Medical College, Haldwani.Associate Professor, Dept. of Pathology, Government Medical College, Haldwani.Assistant Professor, Dept. of Obstetrics and Gynaecology, Government Medical College, Haldwani.Background: Cervical cancer remains a significant global health concern, with early detection through Pap smear cytology playing a pivotal role in reducing morbidity and mortality. Objectives: This retrospective study evaluated the diagnostic accuracy of Pap smears in 2,746 cases, correlating cytological findings with histopathology in 158 cases. Methods: A retrospective analysis was conducted on 2,746 cervical cytology cases from year 2019 to 2024, categorized using the Bethesda System. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and chi-square tests were employed to assess cytology-histopathology concordance. Results: The study demonstrated high sensitivity (94.5%) and negative predictive value (90.3%), confirming the test’s reliability in ruling out disease. However, specificity was modest (50.9%), with frequent false positives in low-grade lesions (ASC-US: 55.6% discordance; AGC: 66.7% discordance), often due to benign mimics like cervicitis. High-grade lesions (HSIL, SCC, adenocarcinoma) showed perfect concordance (100%). Chi-square analysis revealed a significant association between cytology and histopathology (χ² = 87.42, p < 0.001), with subgroup analysis underscoring stronger correlations for high-grade lesions (HSIL/SCC: χ² = 42.36, p < 0.001). Conclusion: These findings highlight the Pap smear’s strength in detecting clinically significant lesions while emphasizing the need for adjunctive tests (e.g., HPV testing) to improve specificity in ambiguous cases.https://www.ojhas.org/issue94/2025-2-1.htmlpapanicolaou (pap) smearcytologycervical cancerprecancerous lesions |
| spellingShingle | Bhagyashree Rituraj Prabhat Pant Preeti Sharma Strengths and Limitations of Pap Smear Screening: When Cytology Succeeds and Where it Fails Online Journal of Health & Allied Sciences papanicolaou (pap) smear cytology cervical cancer precancerous lesions |
| title | Strengths and Limitations of Pap Smear Screening: When Cytology Succeeds and Where it Fails |
| title_full | Strengths and Limitations of Pap Smear Screening: When Cytology Succeeds and Where it Fails |
| title_fullStr | Strengths and Limitations of Pap Smear Screening: When Cytology Succeeds and Where it Fails |
| title_full_unstemmed | Strengths and Limitations of Pap Smear Screening: When Cytology Succeeds and Where it Fails |
| title_short | Strengths and Limitations of Pap Smear Screening: When Cytology Succeeds and Where it Fails |
| title_sort | strengths and limitations of pap smear screening when cytology succeeds and where it fails |
| topic | papanicolaou (pap) smear cytology cervical cancer precancerous lesions |
| url | https://www.ojhas.org/issue94/2025-2-1.html |
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