Study of epithelial cell abnormalities in cervical smear by the Papanicolaou test

Background: Cervical cancer remains a major public health concern in developing countries, where routine screening programs are limited. The Papanicolaou (Pap) test is a simple and effective cytological method for early detection of epithelial cell abnormalities, thereby playing a critical role in reducing the incidence and mortality of cervical cancer. Aims and Objectives: This study aimed to evaluate epithelial cell abnormalities in cervical smears using the Pap test and to categorize the findings based on The Bethesda System (2014). Materials and Methods: This cross-sectional study was conducted in the Department of Pathology at Narendra Modi Medical College over a period of 2 years. A total of 3260 cervical smears were collected from women aged 21–70 years presenting for routine screening or with gynecological symptoms. Samples were stained using the conventional Pap stain and examined microscopically. Cytological findings were classified according to The 2014 Bethesda System for reporting cervical cytology. Results: Out of 3260 smears examined, 98.40% were negative for intraepithelial lesion or malignancy, whereas epithelial abnormalities were noted in 1.60% of cases, including atypical squamous cells of undetermined significance (ASC-US) (0.89%), Atypical squamous cells- cannot exclude HSIL (ASC-H) (0.21%), Atypical glandular cells (AGC) (0.16%), low-grade squamous intraepithelial lesions (0.16%), HSIL (0.12%), and squamous cell carcinoma (0.06%). A significant correlation was identified between epithelial abnormalities and increasing age. Conclusion: The Pap smear continues to be a valuable tool in the early detection of cervical epithelial cell abnormalities. Enhancing public awareness, ensuring regular screening, and timely follow-up of abnormal results are essential steps in cervical cancer prevention and control.