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Age distribution of abnormal pap smear in a secondary hospital in south-west Nigeria

SA Osasan
CA Adepiti
AA Ikuomola
EO Pelemo
BSGB Adeboye
OO Ojuolape


Background: Cervical cancer is a leading cause of cancer death in Sub- Saharan Africa. It is the second commonest cancer in women worldwide. The prevalence of the disease has reduced in developed nations compared to most developing nations as a result of systematic screening programmes. There is no age distribution pattern of abnormal Paps smear in Nigerian women today that can help in the design of a national screening programme.
Objective: To determine the age distribution pattern of abnormal Paps smear in women in our environment in order to have a basis for the points of entry and exit for cervical cancer screening protocol.
Materials and Method: In this retrospective review, the 102 clients who had abnormal smear out of the total 629 clients who had Pap's smear at the State Specialist Hospital, Akure over a period of 5years (2008- 2012) were analyzed for specific diagnosis and their age distribution.
Results: Among the clients with abnormal smear, 57 (55.9%) had ASCUS, 34 (33.3%) had LSIL and 9 (8.8%) of the clients had HSIL. A client each had AGCUS and cancer cytology and was 50 and 60 years old respectively. ASCUS, LSIL and HSIL were found across all age groups except 30years and below where few LSIL were seen.
Conclusion: Screening uptake is still low in our environment and because only few LSIL were seen in Clients ≤30years, it may be cost effective to start screening from 30years and to exit screening at 70years since abnormal smears were still found in women ≥70years.

Key Words: Cervical cancer, Paps smear, screening.