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Prevalence of Abnormal Cervical Cytology in HIV-Negative Women Participating in a Cervical Cancer Screening Program in Calmette Hospital, Cambodia

  • Hav, Monirath (Department of Public Health, University of Sydney) ;
  • Eav, Sokha (Department of Oncology, Calmette Hospital) ;
  • Heang, Nicole (Department of Pathology, Calmette Hospital) ;
  • Pich, Pintuna (Department of Pathology, Calmette Hospital) ;
  • Lim, Davy (Department of Pathology, Calmette Hospital) ;
  • Leang, Vitou (Department of Pathology, Calmette Hospital) ;
  • Korn, Aun (Department of Gynecology, Calmette Hospital) ;
  • Lay, Sanine (Department of Gynecology, Calmette Hospital) ;
  • Pluot, Michel (Anatomic and Cyto-Pathology Laboratory, Reims University Hospital) ;
  • Kruy, Leangsim (Working Group for Cancer Prevention, Ministry of Health)
  • Published : 2016.07.01

Abstract

Background: According to the most recent estimation of GLOBOCAN, Cambodia has the highest incidence and mortality rate of cervical cancer in Southeast Asia. A screen-and-treat strategy using visual inspection with acetic acid (VIA test) and cryotherapy has been implemented in Cambodia's national cervical cancer screening program since 2013. However, where resources are available, cervical cytology with or without high-risk HPV DNA testing is the preferred screening method used in this country. Aim: This study aims to calculate the prevalence of abnormal cervical cytology and explain the possible factors contributing to a reduced quality of cervical cytology among women participating in a hospital-based cervical cancer screening program in Cambodia. Materials and Methods: A descriptive study was conducted using information from the cytology and pathology database in the Department of Pathology of Calmette Hospital between January 2012 and December 2015. Prevalence of abnormal cervical cytology, based on the Bethesda 2001 classification, was calculated. Data on the adequacy of cytological specimens were analyzed in order to explain the factors contributing to a reduced quality of cervical cytology interpretation. Results: Among 6,207 women who participated in the cervical cancer screening program at Calmette Hospital during 2012 and 2015, 388 (6.25%) had abnormal cytology, which could be classified into Atypical Squamous Cells of Undetermined Significance (92 cases; 1.48%), Atypical Squamous Cells - Cannot Exclude High-Grade Intraepithelial Lesion (13 cases; 0.21%), Atypical Glandular Cells (11 cases; 0.18%), Low-Grade Squamous Intraepithelial Lesion (221 cases; 3.56%), High-Grade Squamous Intraepithelial Lesion (26 cases; 0.42%), and Squamous Cell Carcinoma (25 cases; 0.40%). Unsatisfactory smears made up 12.2% of the total cases. The most frequently identified factor leading to unsatisfactory smears was the absence of cells from the transformation zone. Conclusions: The present study showed an overall prevalence of abnormal cervical cytology of 6.25%, which is comparable to that in many large population-based studies in the Asia Pacific region. Nevertheless, the remarkably high rate of unsatisfactory smears in this study justifies further improvement in specimen sampling among Cambodian gynecologists.

Keywords

Cambodia;cervical cancer screening;prevalence of abnormal cervical cytology

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