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Application of Bethesda System For Cervical Cytology at a Tertiary Care Centre


Affiliations
1 Professor & Head, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, India
2 Former PG Resident, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, India
3 Associate Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, India
 

Background: For early screening of the cervical lesion cervical smear is a sensitive test and most widely used system for describing Pap smear result is The Bethesda System. Aims and Objectives: The present study was conducted to look for the epithelial cell abnormalities in cervix using Bethesda system of reporting for cervical cytology, to implicate The Bethesda System of reporting (2014) during assessment of Pap smear, to detect cervical cancer and its pre-cancerous lesions (LSIL-Low grade intraepithelial lesion and HSIL-High grade intraepithelial lesion) at an early stage by Pap smear examination and to create awareness about cervical cancer and importance of Pap smear as a screening test in disease prevention. Materials and Methods: The present study was undertaken at a tertiary health care, out of 250 cervical smears, we excluded 10 smears which were inadequate to opine. So, the total of 240 smears got reported according to The Bethesda System 2014. Observations and Results: The youngest patient was 18 year old and the oldest was 75 year old female. A total of 4% Pap smears were reported as unsatisfactory. The most common complaint of patients was discharge per vaginum which accounts for a total of 38% followed by abdominal pain is showed in 8% of cases. The most common infection was bacterial vaginosis followed by candida, Trichomonas. The frequency of normal (NILM) cases was 78%. ASCUS was found in 4.58%, LSIL was found in 9.17%, HSIL was found in 1.67% & SCC was found in 3.33% cases. Proportion of LSIL was more in age group 41-50 years i.e. 21.15%. Conclusion: Pap test has significant utility worldwide. Bethesda system which is widely used for cervicalcytology is a uniform and standard method for reporting cervical smears. It also gives a descriptive diagnosis that aids the clinicians regarding individualized management of patients. It helps in prevention of invasive cervical cancer by timely detection and treating women having precancerous lesions. The effectiveness is determined by reduction in incidence and mortality.

Keywords

Bethesda System, Cervical Cancer, Infection, Pap Smear, Cervical Cytology
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  • Application of Bethesda System For Cervical Cytology at a Tertiary Care Centre

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Authors

Preeti Bajaj
Professor & Head, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, India
Priyanka Sadashiv Baviskar
Former PG Resident, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, India
Devangana M. Rajyaguru
Associate Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, India
Rajendra A. Chaudhari
Associate Professor, Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422203, Maharashtra, India

Abstract


Background: For early screening of the cervical lesion cervical smear is a sensitive test and most widely used system for describing Pap smear result is The Bethesda System. Aims and Objectives: The present study was conducted to look for the epithelial cell abnormalities in cervix using Bethesda system of reporting for cervical cytology, to implicate The Bethesda System of reporting (2014) during assessment of Pap smear, to detect cervical cancer and its pre-cancerous lesions (LSIL-Low grade intraepithelial lesion and HSIL-High grade intraepithelial lesion) at an early stage by Pap smear examination and to create awareness about cervical cancer and importance of Pap smear as a screening test in disease prevention. Materials and Methods: The present study was undertaken at a tertiary health care, out of 250 cervical smears, we excluded 10 smears which were inadequate to opine. So, the total of 240 smears got reported according to The Bethesda System 2014. Observations and Results: The youngest patient was 18 year old and the oldest was 75 year old female. A total of 4% Pap smears were reported as unsatisfactory. The most common complaint of patients was discharge per vaginum which accounts for a total of 38% followed by abdominal pain is showed in 8% of cases. The most common infection was bacterial vaginosis followed by candida, Trichomonas. The frequency of normal (NILM) cases was 78%. ASCUS was found in 4.58%, LSIL was found in 9.17%, HSIL was found in 1.67% & SCC was found in 3.33% cases. Proportion of LSIL was more in age group 41-50 years i.e. 21.15%. Conclusion: Pap test has significant utility worldwide. Bethesda system which is widely used for cervicalcytology is a uniform and standard method for reporting cervical smears. It also gives a descriptive diagnosis that aids the clinicians regarding individualized management of patients. It helps in prevention of invasive cervical cancer by timely detection and treating women having precancerous lesions. The effectiveness is determined by reduction in incidence and mortality.

Keywords


Bethesda System, Cervical Cancer, Infection, Pap Smear, Cervical Cytology

References