Prevalence of Cervical Pap Smear Epithelial Abnormalities in Iraqi Women and Its Correlation with Histopathology

Background & Objective: Cervical carcinoma is the fourth most common malignancy among women worldwide, with a disproportionately high incidence and mortality in developing countries, including Iraq, where ۳۲۰ new cases and ۶۲ deaths were reported in ۲۰۲۳. Although the Papanicolaou (Pap) smear remains the cornerstone of screening, findings across Arab populations have been inconsistent, underscoring the need for region-specific data. This study aimed to determine the prevalence and patterns of cervical epithelial cell abnormalities and assess the diagnostic accuracy of Pap smears in Najaf, Iraq.Methods: This retrospective, cross-sectional study was conducted over ten years (December ۲۰۱۴–December ۲۰۲۴) and included ۳۵۲۲ cervical Pap smears from women aged ۱۶ to ۸۰ years (mean, ۳۶.۹۷ ± ۱۰.۶۲ years) obtained at a private medical laboratory. Samples were classified according to the ۲۰۱۴ Bethesda System.Results: Of ۳۵۲۲ samples, epithelial cell abnormalities were identified in ۱۹۲ (۵.۴۵%). Atypical squamous cells of undetermined significance (ASC-US) were the most frequent abnormality (۳.۷۸%). The highest prevalence was observed among women aged ۴۰ to ۶۰ years. A strong cytohistopathologic correlation was noted. The Pap test demonstrated a sensitivity of ۷۶.۱۹%, specificity of ۸۰.۳۰%, and overall diagnostic accuracy of ۷۹.۳۱%.Conclusion: The ۵.۴۵% prevalence of epithelial abnormalities, predominantly ASC-US, highlights the ongoing need for active cervical cancer screening programs. The significant concordance between cytologic and histopathologic findings confirms the diagnostic reliability of the Pap smear. Further studies are warranted to characterize local cytologic patterns and identify prevalent HPV genotypes to inform HPV vaccination and targeted prevention strategies.

کلیدواژه ها:

Cervical cancer screening ، Pap smear ، Diagnostic Accuracy