The yield of pap smears and its characteristics in a community based setting in Saudi Arabia

OBJECTIVES: To assess the yield of Papanicolaou tests (pap smears), including the characteristics of abnormal pap smears. METHODS: In this record-based cross-sectional study, we reviewed pap smears of patients seen at the Family Medicine clinics, King Faisal Specialist Hospital and Research Center from January 2002 to January 2017. All women between the ages of 21 and 65 were included. Study-specific case report form was developed to capture patient demographics, pap smear histopathology (Bethesda III System), human papilloma virus polymerase chain reaction (HPV PCR), and the parity status. RESULTS: A total of 3346 patients were included; 2.2% had abnormal pap smear. Most frequent abnormalities were atypical squamous cells of undetermined significance (2%), followed by glandular cell abnormalities (0.8%). Human papilloma virus infection was detected in 6.5% and all other infections were identified in 9.2% of all screened Pap smears. CONCLUSION: Pap smears remain an effective tool for cervical cancer screening. Low yields of pap smears compared to other developed countries could be attributed to lower risk factors for cervical cancer in Saudi Arabia. Routine screening especially among high risk women is strongly recommended.