Opportunistic Cervical Cancer Screening During Antenatal Visits: A Small Step Toward Early Detection

Background Cervical cancer remains a significant public health concern in India. The objective of this study was to compare cytological abnormalities and HPV positivity rates between pregnant and non-pregnant women. Materials and methods This prospective observational study was performed at a tertiary care center in North India. A total of 120 women were included in the study, with 60 in each group. Group A included women who were pregnant, and Group B included non-pregnant women. Conventional Pap smear and co-testing (liquid-based cytology (LBC) and human papillomavirus deoxyribonucleic acid (HPV DNA)) were done on all the participants. The smears were interpreted according to the Bethesda system of classification. The results in the two groups were compared. Follow-up and management were done as per standard guidelines. Results Cervical smear was satisfactory in 112 (93.3%) and 116 (96.7%) of women who underwent conventional Pap smear and LBC, respectively. Among the premalignant lesions in Group A, atypical squamous cells of undetermined significance (ASC-US) were found in four (6.67%) of patients, and low-grade intraepithelial lesion (LSIL) was found in two (3.33%) of patients. In Group B, ASC-US was seen in five (8.33%), LSIL in three (5%), and high-grade squamous intraepithelial lesion (HSIL) in one (1.6%) case, respectively. The women in both groups who tested positive for HPV DNA were retested as per guidelines. Conclusions The prevalence of cytological abnormalities and HPV DNA positivity was corroborated well in both pregnant and non-pregnant women. Due to the increased number of antenatal visits and institutional deliveries, we would like to emphasize that screening for cervical cancer can be done by either HPV DNA or cytology in the antenatal period.