Age and Pattern of Pap

Smear Abnormalities:
Implications for Cervical Cancer
Control in a Developing Country

Pembimbing:
Dr. dr. H. Ferry Yusrizal, Sp.OG (K), M.Kes
1.
Introduction
Cervical cancer is a major public
health problem in many developing
countries with over 75% of incidence
and mortality. Developing countries
bear the brunt of cervical cancer due
to lack of effective population-based
cervical cancer screening program.
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Cervical Cancer
▪ Liquid based cytology (LBS) is meant to detect cervical
👧
premalignant lesions from the cervix  cervical intraepithelial
neoplasma (CIN)
▪ Pap Smear  collection of exfoliated cells from the cervix
onto glass slides which are processed in the laboratory and
examined for the presence of CIN
▪ Pap Smear  every 3 year starting from 21 years old

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2.
Materials and Method
Method Material
The Pap smear results of The data was analyzed with
women attending the Statistical Package for Social
gynecological clinics of a Sciences (SPSS) version 20.
university teaching hospital and
a secondary hospital between
May 2013 and April 2015 were
retrieved from the tumor
registries of both hospitals

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3.
Results
Pap Smear results
Frequency Percentage
Normal 728 40.6
Inflammation 613 34.2
ASCUS 117 6.5
LGSIL 209 11.7
HGSIL 111 6.2
AGC 12 0.7
Suspicious for malignancy 3 0.2
Total 1793 100
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Pattern of Pap Smear

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4.
Discussion
▪ The mean age of the women screened was 45 years
▪ Human papillomavirus (HPV) the causative organism
of cervical cancer is mainly sexually transmitted (STD).
▪ CIN peaks after 10 years after the peak incidence of HPV
infection and a decade earlier than invasive cervical cancer 
screening starts at the age of 20 and over
▪ Implication of finding: Women with premalignant condition
can be detected and treated early.

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5.
Critical Appraisal
Population Intervention
Women attending the Data collected from medical records of
gynecological clinics of a women attending the gynecological clinics of a
university teaching university teaching hospital and a secondary
hospital and a secondary hospital between May 2013 and April 2015
hospital between May
2013 and April 2015 Outcome
resulting in 2048 samples Of the 2048 women included in the analysis,
in total
- 728 samples Normal
Comparison - 117 (6.5%) samples ASCUS,
This study discusses the - 209 (11.7%) samples LGSIL
group of women based
- 111 (6.2%) samples HGSIL
on their ages who have
done Pap smears with - AGC 12 samples and malignancy 3 samples
abnormalities found.
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Validity
▪ Is the research question well-defined that can be answered using this study
design?  Yes, this study aimed to group women based on their
age and pap smear findings
▪ Yes,
Does the author use appropriate methods to answer their questions? 
the method in this study is in accordance with the purpose of
the study (to collect data of women who were examined with
Pap smear for 11 months)
▪ Yes, the
Is the data collected in accordance with the purpose of research? 
data was taken from medical records of hospital patients in
May 2013 to April 2015 in Southwest Nigeria who came to the
gynecology department of the Obafemi Owolowo university
hospital. 14
Importance
▪ Yes, this study is important to know the
Is this study important? 
prevalence of women examined using Pap smears. This
examination can detect abnormalities in cervical epithelial
cells and can be treated so as not to develop into malignancy
in the cervix that has a high mortality rate

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Applicability
▪ Are your patient so different from these studied that the results may not apply
to them?  No, because the results of this study can be used in
developing countries such as Indonesia, which also has
poverty problems and poor health care.
▪ Is your environment so different from the one in the study that the methods
could not be use there?  No, the results of this study can be
applied, the method used in this study can also be applied in
Indonesia for the benefit of further research.

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6.
Conclusion
Research of this journal is Valid,
Important and Applicable
and so this journal can be used as a
reference.

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Thanks!
Any questions?

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