Randomly selected smear test screening outcome

Abstract EN

Background : The cervical cancer screening coverage in Bahrain was 43.1 % in 2018.

Even with the presence of a screening program, most screening in the Middle East usually take place at random.

Objective : To evaluate the risk factors and outcome of randomly selected smear tests.

Design : A Retrospective Study.

Setting : Bahrain Defence Force Hospital, Bahrain.

Method : All Pap smear tests performed from January 2017 to December 2017 were included in the study.

The smear results were divided into four groups: normal, borderline, premalignant changes and malignant changes.

Risk factors such as age, parity, contraceptive/medical history, smoking, and human papillomavirus (HPV) positive screening were documented.

The outcome of care were divided into four categories: repeat smear test, colposcopy and cervical biopsy, hysteroscopy/dilatation and curettage, and hysterectomy.

Result: A total of 2,626 smear tests were included in the study; 2,246 (85.5 %) were negative smears.

Two hundred forty (9 %) were borderline and 135 (5 %) had pre-cancerous lesions.

Five (0.2 %) cases were malignant; the older the patient, the higher the risk of malignant changes.

Twenty-nine (1.1 %) of the previous pre-cancerous smear became negative on the successive smear and 72 (2.7%) patients had repeat smear test.

Some of the negative and borderline patients had a hysterectomy.

Conclusion : A uniform cervical screening policy must be initiated and cost-effective clear protocols must be laid down to improve the quality of women’s health in Bahrain.