Diagnostic accuracy of cervical cytology with histopathological correlation in a tertiary care hospital

Abstract

Cervical cancer remains a major health burden in developing countries, where limited screening resources contribute to late diagnosis and high mortality. Cervical cytology plays a pivotal role in detecting premalignant lesions and preventing progression to invasive carcinoma; however, interpretation accuracy can vary. Therefore, correlation with histopathology is necessary to assess diagnostic reliability. This study aimed to evaluate the diagnostic performance of Pap smear cytology and its correlation with histopathological findings. A retrospective observational study was conducted in a tertiary care hospital including 149 women who underwent Pap smear examination followed by cervical biopsy or hysterectomy within three months. Cytological findings were reported using The Bethesda System, and final histopathology served as the gold standard. Patient demographic data, clinical presentations, and cyto-histo diagnostic agreement were analyzed. The majority of affected women belonged to the 31-40 years age group, and vaginal discharge was the most frequent presenting symptom. Negative for intraepithelial lesion or malignancy was the commonest cytological interpretation. Among abnormal smears, ASC-US, LSIL, and HSIL constituted the major epithelial abnormalities. Histopathology predominantly showed chronic cervicitis, while only a small proportion demonstrated premalignant or malignant lesions. This study affirms cervical cytology as a simple and valuable screening method but underscores the need for confirmatory histopathology in suspicious or symptomatic cases. Incorporating HPV testing may further enhance early detection and improve cervical cancer prevention outcomes.