Profile of Pap smear cytology in the Western region of Saudi Arabia

OBJECTIVE: Cervical carcinoma is an important womens health problem in the Western countries. There are only few published data on this disease in the Kingdom of Saudi Arabia (KSA). The aim of this study is to evaluate the abnormal cytological entities detected by cervical Pap smear in Western region of KSA and to discuss the importance of Pap smears screening programs.

METHODS: Retrospective review of all the cervical smears present at the King Abdul-Aziz University Hospital, Jeddah, KSA from 1984 to 2000. The reports of 22089 smears were retrieved from the file of the pathology department.

RESULTS: There were 368 (1.66%) abnormal Pap smears out of 22089 smears. Out of these 368 abnormal Pap smears there were 62 (16.8%, mean age 37 year) cervical intraepithelial neoplasia grade 1, 45 (12.2%, mean age 38.5) cervical intraepithelial neoplasia grade 2, 27 (7.3%, mean age 40.5) cervical intraepithelial neoplasia grade 3, 22 (6%, mean age 38.5) positive for malignant cells, 36 (9.8%, mean age 40.5) atypical endocervical cells, 88 (23.9%, mean age 39) atypical squamous cells, 9 (2.4%, mean age 40.5) squamous metaplasia with atypia, 26 (7.1%, mean age 45) squamous cell carcinoma, 6 (1.6%, mean age 36.5) reparative atypia, 2 (5.4% mean age 35) herpes virus changes, 19 (5.1%, mean age 37.5) human papilloma virus changes, 5 (1.4%, mean age 55) adenocarcinoma of endometrium, and 7 (1.9%, men age 43.5) adenocarcinoma of endocervix.

CONCLUSION: Cervical intraepithelial neoplasia and invasive cervical carcinoma are less common in KSA compared to the Western countries, however, cervical screening programs are necessary nationwide to estimate the actual magnitude of cervical carcinoma and its precursor lesions.