Prevalence of Abnormal Papanicolaou Test Results and Related Factors among Women Living in Zanjan, Iran

  • Maleki, Azam (School of Nursing and Midwifery, Zanjan University of Medical Sciences) ;
  • Ahmadnia, Elahe (School of Nursing and Midwifery, Zanjan University of Medical Sciences) ;
  • Avazeh, Azar (Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences) ;
  • Mazloomzadeh, Saeideh (Zajan Social Determinants of Health Research Center) ;
  • Molaei, Behnaz (Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences) ;
  • Jalilvand, Ahmad (Department of Pathology, Zanjan University of Medical Sciences)
  • Published : 2015.11.04


Background: Currently, a comprehensive program for screening and early detection of cervical cancer does not exist in Iran. This study aimed to determine the prevalence of abnormal Papanicolaou (Pap) smears and some related factors among women living in Zanjan, Iran. Materials and Methods: This cross-sectional study was conducted in 2012 in Zanjan on 4274 married women aged 20-65 years. The study participants were selected through two-stage cluster sampling. After obtaining written consent, demographic and fertility questionnaires were completed. Samples from cervix were obtained through a standard method using the Rover Cervex- Brush. Evaluation and interpretation of the samples were reported using the Bethesda 2001 method. Data were statistically analyzed using chi-square and logistic regression models. Results: Most inflammatory changes in the samples were mild (37.4%). Abnormal atypical changes in the epithelial cells were found in 4.04%. The highest percentage of abnormal changes in the epithelial cells was atypical squamous cells of undetermined significance (ASCUS) (1.9%). Abnormal results of Pap smear was significantly and independently associated with age, papillomavirus infection, and lack of awareness about Pap smear tests. Conclusions: Given the high prevalence of inflammatory and precancerous changes in this study, compared to other studies in Iran and other Muslim countries, and the effect of demographic variables and individual factors on abnormal results, increasing the awareness of women and their families regarding the risk factors for cervical cancer, preventive measures such as screening, and timely treatment seem necessary.


Uterine cervical neoplasms;cervical intraepithelial neoplasia;Papanicolaou test;Iran


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