• Annals of Saudi medicine · Jul 2017

    Eleven-year review of data on Pap smears in Saudi Arabia: We need more focus on glandular abnormalities!

    • Haitham Nasser, Mohammad AlAyyaf, Azza Atallah, Mohammad Aminulislam, Lubna Rizwan, Abdulsalam Aodah, Yasser Alkahtani, Haifa Alshammari, Ahmed Alsayed, and Susan Szpunar.
    • Dr. Haitham Nasser, Department of Histopathology,, King Saud Medical City,, Riyadh 11575, T: +966-11-4355555;, F: +966-11-4353045, samnasser78@gmail.com, ORCID: http://orcid.org/0000-0001-5939-1542.
    • Ann Saudi Med. 2017 Jul 1; 37 (4): 265271265-271.

    BackgroundWe reviewed data from Saudi Arabia on epithelial cell abnormalities (ECA) detected by Pap smear after noticing a slight increase in the incidence of cervical glandular abnormalities in our regional laboratory in recent years.ObjectiveClarify data on adenocarcinoma (ADCA) on Pap smears in Saudi Arabia.DesignDescriptive, retrospective study.SettingsRegional laboratory, Riyadh.Patients And MethodsWe reviewed all Pap smears of adult females between 2006 and 2016 and compared our data with previously published results from Saudi Arabia.Main Outcome Measure(S)Descriptive data on ECAs.ResultsAmong 19759 cases, atypical squamous cell of undetermined significance (ASC-US) was the most prevalent ECA (1.16%). ADCA occurred more than squamous cell carcinoma (SCC). In a comparison of published data before 2014 and after 2014 (including ours), there was a significant rise in ADCA (28 vs 48 cases; P=.004) with a significant drop in SCC, high-grade squamous intraepithelial lesions (HSIL) and low-grade squamous intraepithelial lesions (LSIL) (P < .0001, .004, and < .0001, respectively).ConclusionWe recommend that pathologists and cytotechnologists be vigilant in screening Pap smears in our population, particularly for glandular abnormalities. We also recommend use of Pap smears in the initial workup of women with suspected gynecological abnormalities, regardless of evolutions in HPV testing.LimitationsThe pooling of data instead of analyzing by study year.

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