CERVICAL CYTOLOGY SCREENING PATTERNS AND OUTCOMES: A SEVEN- YEAR RETROSPECTIVE ANALYSIS AT FEDERAL MEDICAL CENTRE, UMUAHIA
Formerly Published in Vol. 14 No. 7 Jan. - Jun., 2026
Keywords:
Cervical cytology, Pap smear, Bethesda System, screening, cervical cancer, Nigeria, Southeast Nigeria, Abia StateAbstract
Background: Cervical cancer remains a significant public health concern globally, with the highest burden in low- and middle-income countries. Cytology-based screening using the Papanicolaou (Pap) smear test has been the cornerstone of cervical cancer prevention programs. Understanding local screening patterns and cytological findings is essential for effective cervical cancer control strategies. Objective: This study aimed to analyze the patterns, distribution, and outcomes of cervicalcytology screening at Federal Medical Centre, Umuahia over a seven-year period (2018-2024), evaluate the prevalence of epithelial cell abnormalities, and determine age-specific screening patterns.
Methods: A retrospective descriptive study was conducted analyzing 1,092 Pap smear records from January 2018 to December 2024. Data extracted included patient age, clinical indications, and cytological diagnoses classified according to the 2014 Bethesda System. Descriptive statistics, chi-square tests, independent t- tests, and one-way ANOVA were used for statistical analysis.
Results: The study analyzed 1,092 cervical cytology specimens with a mean patient age of 40.99 ± 11.72 years. Peak screening occurred in the 30–39 years age group (37.0%). Negative or intraepithelial lesion or malignancy (NILM) accounted for 93.4% of diagnoses. Epithelial cell abnormalities were detected in 4.16% of the 1,083 satisfactory specimens (excluding 9 unsatisfactory cases from the denominator), with ASCUS being the most common (1.75%). he ASCUS:SIL ratio was 1.36:1, a key benchmark of diagnostic tringency indicating that ASCUS is not being overused relative to definitive squamous intraepithelial lesion diagnoses, ith an optimal range of 1:1 to 2:1. The unsatisfactory specimen rate was remarkably low at 0.82%. Women with abnormal cytology were significantly older (mean 50.81 vs 40.56 years, p<0.0001). Pioneer Medical Journal 1 Vol 14. No 7. Jan – Jun. 2026 Jegede et al., Cervical Cytology Screening Pattern
Conclusion: This study demonstrates a low prevalenceof cervical cytological abnormalities nd excellent quality indicators (unsatisfactory rate 0.82%; optimal ASCUS:SIL ratio 1.36:1) at our center. The significant age difference between normal and abnormal cytology (mean 50.81 vs 40.56 years, p<0.0001) underscores that the current opportunistic screening model is systematically missing the highest-risk demographic: women over 50 years. A specific policy shift is recommended, targeting catch-up cervical screening for all women over 50 presenting at any hospital clinic, not just gynecology. Enhanced community awareness and expanded targeted screening programs are essential.
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References
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