The Frequency of Unsatisfactory Pap Smears Based on the Bethesda System-2001 and their Reasons

Zarrin Ajoodani^1*, Shahnaz Babayanzad Ahari² and Sedigheh Nasrollahi³

¹Assistant Professor of Obstetrics and Gynecology, Faculty of Nursing and Midwifery, Islamic Azad University, Karaj Branch, Karaj, Iran. ²M.Sc. of midwifery, Iranian Social Security Organization, Alborz Hospital, Karaj, Iran. ³M.Sc. of midwifery, Faculty of Nursing and Midwifery, Islamic Azad University, Karaj Branch, Karaj, Iran.

DOI : http://dx.doi.org/10.13005/bbra/2217

ABSTRACT: Cervical cytology is widely used for primary screening of cervical cancer. Once the Pap smear is reported as unsatisfactory for evaluation, the cervical intraepithelial lesions cannot be certainly diagnosed, which leads to false negative results. We investigated the frequency of unsatisfactory smears and their reasons. This prospective descriptive analytical study was conducted from June 2011 to September 2013, on women having Pap smear in Gynecology Clinic of Alborz Hospital in Karaj, Iran. The tests were done conventionally by cervical brush and then adequacy of specimens was assessed based on Bethesda system 2001 by one pathologist. Of 1557 cervical cytology specimens, the frequency of satisfactory and unsatisfactory smears were 445 (92.8%) and 112 (7.2%), respectively. The reasons for unsatisfactory smear included obscured by inflammation in 48 (42.9%) cases, obscured by blood in 42 (37.5%), insufficient cellularityin 11(9.8%), and poor fixation in 11 (9.8%). The results of this study showed that sampling by trained personnel, persistent supervision and use of appropriate equipment can reduce unsatisfactory Pap smears.

KEYWORDS: Pap smear; Smear adequacy; Unsatisfactory smear

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