Abnormal Pap Smear in Chaoprayayomraj Hospital-ความผิดปรกติของเซลล์เยื่อบุปากมดลูก ในโรงพยาบาลเจ้าพระยายมราช

Abstract

               The objective of this retrospective descriptive study was to study the incidence of abnormal Pap smear in Chaoprayayomraj Hospital. It reviewed 122,314 Pap smears screening results from Cytology unit during October 2002 - September 2006 and additional records from the inpatient unit.
There were 665 cases (0.543%) (95%CI 0.505-0.581) that showed abnormal cytology with an average age of 43.01 years (SD 11.505). Most abnormal Pap smear was 353 (53%) presented in women between 35-49 years and HSIL was the most abnormal Pap in 373 women (56.1%). Colposcopic finding, pathologic result from biopsy and LEEP (Loop Electrosurgical Excision Prcedure) in 409 cases led to 155 cases of hysterectomy. In all, 51 micro invasive cancer cases were found (7.67%). The correlation between age and abnormal Pap smear was statistically significant (2=20.063, p=.000, 95%CI=1.612, 3.459). The women aged more than 35 years had higher possibility of having abnormal Pap smear. The higher the level of abnormal Pap smear would predict, the higher the level abnormal biopsy result with statistical significance (2=85.576, p=.000, 95%CI=4.360, 10.468). Six months after finding of abnormal Pap smear, 78.2 percent of the patients were followed up and only 8.82 percent remained in the program after two years. In conclusion, effective control of cervical cancer required early detection among the high risk group (more than 35 years), management of abnormal Pap smear, systemic clinical guideline, referral system and strict follow up system.

Key words: abnormal Pap smear, HSIL, micro invasive cancer