- Volume 17 Issue 8
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Prevalence and Risk Assessment of Cervical Cancer Screening by Papanicolaou Smear and Visual Inspection with Acetic Acid for Pregnant Women at a Thai Provincial Hospital
- Lertcharernrit, Jiraporn (Department of Obstetrics and Gynecology, Prapokklao Hospital) ;
- Sananpanichkul, Panya (Department of Obstetrics and Gynecology, Prapokklao Hospital) ;
- Suknikhom, Wineeya (Department of Obstetrics and Gynecology, Prapokklao Hospital) ;
- Bhamarapravatana, Kornkarn (Department of Preclinical Science, Thammasat University) ;
- Suwannarurk, Komsun (Department of Obstetrics and Gynecology, Thammasat University) ;
- Leaungsomnapa, Yosapon (Department of Pediatric, Adult and Elderly, Phrapokklao Nursing College)
- Published : 2016.08.01
Background: Cervical cancer is the second most common in Thailand, but the mortality rate may be rising yearly. It is a cancer that can be prevented by early screening for precancerous lesions, several methods being available. Objective: To identify the prevalence of abnormal Papanicolaou (Pap) smears and lesions with visual inspection with acetic acid (VIA) in pregnant women and assess risk factors for this group. Materials and Methods: This prospective study was performed at Prapokklao Hospital, Thailand during April-July 2016. All pregnant women of gestational age between 12-36 weeks who attended an antenatal clinic were recruited. All participants were screened for cervical cancer by Pap smear and VIA. If results of one or both were abnormal, colposcopic examination was evaluated by gynecologic oncologist. Results: A total of 414 pregnant women were recruited. Prevalence of abnormal Pap smear and VIA were 6.0 and 6.7 percent, respectively. The most common abnormal Pap smear was low grade intraepithelial lesion (LSIL, 44%). Factors associated with abnormal Pap smear in pregnant women were low BMI, multiple partners and being a government officer. In pregnancy, Pap smear had higher sensitivity and specificity than VIA for detection of precancerous cervical lesion. Patients with young coitarche or more than 25 years of active sexual activity were high risk groups. Conclusions: Prevalence of abnormal Pap smear and VIA in pregnant women was 6.0 and 6.7 percent, respectively. Factors associated with abnormal Pap smear were coitarche, years of sexual activity, low BMI, multiple partners and being a government officer.
Supported by : Research Institute of Prapokklao Hospital
- Bouayed J, Bohn T (2010). Exogenous antioxidants--Doubleedged swords in cellular redox state: Health beneficial effects at physiologic doses versus deleterious effects at high doses. Oxid Med Cell Longev, 3, 228-37. https://doi.org/10.4161/oxim.3.4.12858
- Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al (2014). Williams Obstetrics. 24thed. New York: McGraw-Hill.
- Department of Disease Control, Ministry of Public Health (2015). Annual Report 2015. Nontaburi: Bureau of Non communicable Disease, 104.
- Dinc A (2012). Pap smear screening results for Turkish pregnant women. Asian Pac J Cancer Prev, 13, 5835-8. https://doi.org/10.7314/APJCP.2012.13.11.5835
- Diplock AT, Charleux JL, Crozier-Willi G, et al (1998). Functional food science and defence against reactive oxidative species. Br J Nutr, 80, 77-112. https://doi.org/10.1079/BJN19980106
- Ferlay J, Parkin DM, Pisani P (1998). Cancer incidence and mortality worldwide. IARC Press, Lyon, France.
- Ferris DG, Greenberg MD (1994). Reid's Colposcopic Index. J Fam Pract, 39, 65-70.
- Hong JN, Berggren EK, Campbell SL, Smith JS, Rahangdale L (2014). Abnormal cervical cancer screening in pregnancy and preterm delivery. Paediatr Perinat Epidemiol, 28, 97-301. https://doi.org/10.1111/ppe.12104
- Ingprasarn A, Onaium N (2014). Prevalence of abnormal conventional Pap smear in pregnant women, Chonburi Hospital. Thai J Obstet Gynaecol, 22, 137-42.
- Khaengkhor P, Mairaing K, Suwannarurk K, Thaweekul Y, Poomtavorn Y, Pattaraarchachai J, et al (2011). Prevalence of abnormal cervical cytology by liquid based cytology in the antenatal care clinic, Thammasat University Hospital. J Med Assoc Thai, 94, 152-8.
- Khanuja E, Ghosh UK, Garg P, Tomar G, Madan M, Bansal R (2014). A study of cervical intraepithelial neoplasia in pregnancy. J Obstet Gynaecol India, 64, 193-6. https://doi.org/10.1007/s13224-013-0499-7
- Loomis DM, Pastore PA, Rejman K, Gutierrez KL, Bethea B (2009). Cervical cytology in vulnerable pregnant women. J Am Acad Nurse Pract, 21, 287-94. https://doi.org/10.1111/j.1745-7599.2009.00407.x
- Moore MA, Tajima K (2004). Cervical cancer in the Asian pacific-epidemiology, screening and treatment. Asian Pac J Cancer Prev, 5, 349-61.
- Ngaojaruwong N, Vuthiwong C, Punpuckdeekoon P, Thongsorn N (2008). Prevalence of abnormal papanicolaou smear in pregnant women at Phramongkutklao Hospital. Thai J Obstet Gynaecol, 16, 179-85.
- Perksanusak T, Sananpanichkul P, Chirdchim W, Bhamarapravatana K, Suwannarurk K (2015). Colposcopy requirement of papanicolaou smear after atypical squamous cells of undetermined significance (ASC-US) by follow-up protocol in an urban gynaecology clinic, a retrospective study in Thailand. Asian Pac J Cancer Prev, 16, 4977-80. https://doi.org/10.7314/APJCP.2015.16.12.4977
- Priyadhashini M, Panicker V, Seetha V (2013). Screening for cervical cancer in pregnancy-our experience. Indian Journal of Public Health Research & Development, 4, 202-6.
- Silvia DS, Mireia D, Xavier C, Gary C, Laia B, Nubia M, et al (2007). Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis, 7, 453-9. https://doi.org/10.1016/S1473-3099(07)70158-5
- Sueblinvong T, Suwannarurk K, Chanthasenanont A, Treetampinich C, Pongrojpaw D (2005). Prevalence and management of abnormal pap smear in antenatal care clinic at Thammasat University Hospital. J Med Assoc Thai, 88, 133-7.
- The International Agency for Resarch on Cancer (IARC). Testing and reporting the results of visual inspection with 5% acetic acid (VIA) [Internet]. Lyon: IARC; 2016 [cited 2016 Aug 8] Available from: http://screening.iarc.fr/viavilichap2.php?lang=1
- The International Agency for Resarch on Cancer (IARC). The Bethesda System [Internet]. Lyon: IARC; 2016 [cited 2016 Aug 8] available from: http://screening.iarc.fr/atlasclassifbethesda.php
- Valko M, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J (2007). Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol, 39, 44-84. https://doi.org/10.1016/j.biocel.2006.07.001
- Xavier-Junior JC, Dufloth RM, do Vale DB, Tavares TA, Zeferino LC (2014). High-grade squamous intraepithelial lesions in pregnant and non-pregnant women. Eur J Obstet Gynecol Reprod Biol, 175, 103-6. https://doi.org/10.1016/j.ejogrb.2014.01.018