Changing pattern of epithelial cell abnormalities using revised Bethesda system

Area of Science:

• Gynecologic Pathology
• Cytopathology
• Public Health

Background:

• Cervical cancer is a significant cause of mortality among women globally.
• Limited data exists on the prevalence and patterns of abnormal Pap smears in Saudi Arabia using the Revised Bethesda System (RBS).

Purpose of the Study:

• To investigate the changing patterns of epithelial cell abnormalities (ECA) detected in Pap smears (PS).
• To analyze the frequency and types of ECA in women from the Western region of Saudi Arabia.

Main Methods:

• A retrospective study reviewed 15,805 Pap smears from January 2000 to October 2012.
• The Revised Bethesda System (RBS) was used for classification.
• Cytological findings and age distribution were analyzed.

Main Results:

• Epithelial cell abnormalities (ECA) were detected in 14.52% (2295 cases) of the analyzed Pap smears.
• The most common abnormalities included Atypical Squamous Cells of Undetermined Significance (ASC-US) at 7.1% and Low-Grade Squamous Intraepithelial Lesion (LSIL) at 2.2%.
• Higher-grade lesions like High-Grade Squamous Intraepithelial Lesion (HSIL) were observed in 0.8% of smears.

Conclusions:

• The incidence of abnormal Pap smears in Saudi Arabia shows an increasing trend over the past decade.
• The findings underscore the critical need for implementing and expanding mass screening programs for cervical cancer.
• Regular screening can aid in early detection and management of precancerous lesions.