STUDY OF CERVICAL CYTOLOGY IN MENOPAUSAL WOMEN- IN A MATERNITY AND GENERAL HOSPITAL, HYDERABAD, ANDHRA PRADESH

INTRODUCTION: Cytology, today, is widely used for detection of lesions in the cervix. The realization that invasive cancer of the cervix is preceded by recognizable precancerous histological and cytological changes was one of the most basic contributions that aroused greater interest in the possibility of preventing cancer by early cytological detection. OBJECTIVE: The objective of the study is to investigate the incidence of different epithelial abnormalities of the cervix in menopausal and perimenopausal women and compare them with the incidence found in reproductive age group. METHODOLOGY: It is a cross sectional observational study. This study was undertaken to study the cytological features of various lesions in the uterine cervix of different age group patients attending the Gynecological out-patient department of Aparna Maternity and General Hospital, Nagole, Hyderabad from January 2011 to January 2013. INCLUSION CRITERIA: Women of reproductive, perimenopausal (from 40 years) and menopausal age group coming to Out Patient Department for Gynecological checkup. EXCLUSION CRITERIA: Women with following history were excluded from the study: Menstruating / active vaginal bleeding, Inaccessible cervix (due to cervical stenosis or cervix is in flush with vagina), Pregnant women, Hysterectomized women. RESULTS: In this study, satisfactory cervical smear for evaluation were obtained in 953 cases (95.3%). These smear contained squamous epithelial cells spreaded over more than 10% of the slide surface and there were accompanied endocervical cell clusters. In 42 cases (4.2%), the cervical smears were satisfactory, but limited by lack of an endocervical component. In the remaining five patients (0.5%), the cervical smears were sparsely cellular and obscured by blood and mucinous material. In these five cases, smears were unsatisfactory for evaluation. The study shows the incidence of the clinical lesions in the female genital tract. The incidences of SIL and Frank cancer are, highly associated with the suspicious cervix of about 21 %. CONCLUSION: The present study reveals the incidence of different epithelial abnormalities of the cervix in menopausal women compared there with incidence found in women of reproductive age. The present study revealed a high incidence of LSIL and Frank cancer in Menopausal women. Both SIL and cervical carcinoma are associated with multiparity and were commonly observed in women with suspicious cervix and those presenting with bleeding problems. Hence to conclude, cytological screening is mandatory for early detection of SIL, treatment of which would assist in checking in progression of the diseases.