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Updated: Jul 14, 2026

Collection, Isolation, and Flow Cytometric Analysis of Human Endocervical Samples
Published on: July 6, 2014
Cervical intraepithelial neoplasia in Jordan: A ten year retrospective cytoepidemiologic study
Y F Dajani1, U M Maayta, Y R Abu-Ghosh
1Consulting Medical Laboratories, Amman, Jordan.
Insights
Cervical intraepithelial neoplasia (CIN) occurred in 1.1% of females in Jordan. Papanicolaou (Pap) smears are valuable for detecting CIN in Jordanian women over 20, particularly those over 35.
Area of Science:
- Gynecology
- Oncology
- Public Health
Background:
- Cervical intraepithelial neoplasia (CIN) is a significant public health concern.
- Understanding the epidemiology of CIN in different regions is crucial for targeted screening and prevention strategies.
- Previous data on CIN occurrence in Jordan was limited.
Purpose of the Study:
- To determine the frequency and incidence of CIN in females attending obstetric and gynecology clinics in Jordan.
- To analyze the grading of CIN cases and their correlation with cytological findings.
- To identify potential risk factors associated with CIN occurrence in the Jordanian population.
Main Methods:
- A retrospective study of 10,659 females attending obstetric and gynecology clinics in Jordan from 1982 to 1991.
- Analysis of CIN occurrence, frequency rates, and incidence rates.
- Histological grading of CIN cases and comparison with cytological results.
- Investigation of potential associations between CIN and factors such as circumcision of male partners, marital status, age at marriage, parity, breastfeeding, contraceptive pill use, socioeconomic status, and menstrual disorders.
Main Results:
- The overall frequency of CIN was 1.1% (121 cases) among 10,659 females.
- The incidence rate in routine check-up attendees was 49 per 100,000 Jordanian females.
- CIN cases were graded as Grade I (21%), Grade II (48%), and Grade III (31%).
- Histological grading correlated with cytology in 70% of cases, with 30% showing cytologic underrating.
- Circumcision in male partners and marital status were associated with a lower frequency of CIN.
- No significant relationship was found between CIN frequency and age at marriage, parity, breastfeeding, contraceptive pill use, socioeconomic status, or menstrual disorders.
Conclusions:
- CIN occurrence in Jordanian females is substantial, though lower than in high-incidence areas.
- Papanicolaou (Pap) smears are valuable for detecting CIN in Jordanian females over 20, especially those over 35 attending gynecological clinics.
- Further studies are needed to determine the incidence of CIN in the general female population in Jordan.
Abstract:
Occurrence of cervical intraepithelial neoplasia (CIN) was studied in 10,659 females attending obstetric and gynecology clinics in Jordan. The frequency rate of intraepithelial neoplasia was 1.1% in 7743 Jordanian females and 2916 non-Jordanian residents of younger age during the period from 1982 to 1991 inclusive. The incidence rate in 2649 Jordanian females, selected because they attended only for routine checkup, was 49 per 100,000. There were 121 CIN cases which were graded into Grade I (21%), II (48%) and III (31%) respectively. Histological grading correlated with cytology in 70% of the cases while in the remaining 30%, cytologic underrating by one grade was noted; evidence against any overdiagnosis of CIN in our series. Study of the human papillomavirus (HPV) was outside the scope of this effort. However, circumcision in male partners and marital status were associated with a lower frequency of CIN. Age at marriage and average duration, parity, breast feeding, the contraceptive pill, socioeconomic status and menstrual disorders showed no relationship to the frequency of CIN in our patients. Any differences in the latter between Jordanian and non-Jordanian females are believed due to cultural factors. Conization in 27 cases proved effective at 30 months' follow-up. Occurrence of CIN in Jordanian females appears substantial although much lower than that seen in high incidence zones, while its incidence in the general female population remains to be determined. This study shows for the first time the value of Papanicolaou (Pap) smears in Jordanian females over 20 years of age with special emphasis on those over 35 years of age attending obstetric and gynecology clinics.
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