Detection of Epithelial Cells Abnormality on Pap Smear and Correlation with Cervical Punch Biopsy in a Tertiary Level Hospital

Abstract

Background
Cervical cancer is the leading cause of death among female population of Nepal. In the low resource settings in a developing country like Nepal, where ancillary tests may not be available, a Papanicolaou (Pap) test is the mainstay of screening system for cervical cancer. Pap test is a cytological screening technique proposed by The Bethesda System for Reporting Cervical Cytology (TBSRC) at 1988. It is a simple, safe and non- invasive method for detection of epithelial cells abnormalities on cervical smear.
Methods
This is a hospital based cross sectional study conducted over a period of 18 months, from January 2024 to June 2025. Study included 5543 Pap smear and 149 cervical biopsies over the period. Data were collected in Microsoft excel and subjected to SPSS to see the association of pap smear test and biopsy.
Results
In our study, the samples were received from patients aged 21 to 83 years of age. Only 1.4% of total cases studied showed epithelial cell abnormality. The study showed that Pap smear test has high sensitivity, specificity, positive predictive value and negative predictive value of 77.9%, 84%, 80.3% and 81.9% respectively with diagnostic accuracy of 81.20%.
Conclusions
This study revealed that Pap smear test is still a good screening technique to detect epithelial cell abnormality in cervical smear with high diagnostic accuracy in the developing country like Nepal.