Analysis of Cervical Cytology Reports From Pap Smears and Their Clinical Correlation Among Women Attending a Gynecology OPD in a Tertiary Care Center in Northeast India

Introduction: Cervical cancer remains a major global health concern among women, contributing significantly to morbidity and mortality. Timely screening, particularly through cytological methods such as the Papanicolaou (Pap) smear, plays a crucial role in the early detection of precancerous lesions and reduction of disease burden. Aims: To evaluate the effectiveness of Pap smear cytology in detecting cervical cytological abnormalities and to identify factors associated with precancerous cervical lesions. Methods: This study included sexually active women aged 18 years and above. Cervical samples were collected using an Ayre spatula, smeared on grease-free glass slides, and fixed in 95% ethyl alcohol for cytological evaluation. Results: Epithelial cell abnormalities were most commonly observed in multiparous women aged 31-50 years. A substantial proportion of women were asymptomatic (188, 30.4%), while vaginal discharge was the most frequent complaint (182, 29.4%). Cytology revealed inflammatory smears in 364 (58.8%) cases, atypical squamous cells of undetermined significance (ASCUS) in 26 (4.2%), low-grade squamous intraepithelial lesion (LSIL) in 11 (1.8%), and high-grade squamous intraepithelial lesion (HSIL) in 6 (1%). Multivariate analysis showed that early age at first intercourse, contact bleeding, and cervical erosion were significantly associated with an increased risk of precancerous lesions, whereas higher educational status and a normal-appearing cervix were associated with a reduced risk. Other variables such as age, parity, socioeconomic status, oral contraceptive use, and duration of marriage showed no significant association. Conclusions: The findings reinforce the importance of initiating cervical cancer screening from 25 to 30 years of age. Pap smear remains a simple, affordable, and non-invasive method for early detection of precancerous cervical lesions, particularly valuable in resource-limited settings like India.