Abstract / Summary
Background: Cervical cancer remains a major cause of morbidity and mortality among women, particularly in developing countries. Cervical cytology (Pap smear) is a simple, economical, and effective method for early detection of premalignant and malignant cervical lesions. Aims and Objectives: The aims of this study were to evaluate cervical epithelial abnormalities according to the Bethesda System, determine their prevalence in perimenopausal and postmenopausal women, and assess associations with age and clinical presentation. Materials and Methods: This hospital-based prospective study included 250 satisfactory cervical smears from women aged ≥35 years attending the Department of Gynecology, L.G. General Hospital, AMC MET Medical College. Menopausal status was determined from menstrual history and clinical records. Smears were collected using Ayre’s spatula and cytobrush, stained by the Papanicolaou method, and reported per the Bethesda System. Clinical and demographic data were analyzed descriptively. Results: Of 250 smears, 208 (83.2%) were negative for intraepithelial lesion or malignancy, with inflammatory changes being most common (132; 52.8%). Epithelial abnormalities were detected in 42 (16.8%) cases. Atypical squamous cells of undetermined significance (ASC-US) were predominant (21; 8.4%), followed by high-grade squamous intraepithelial lesion (HSIL) (6; 2.4%), atypical glandular cells-not otherwise specified (6; 2.4%), low-grade squamous intraepithelial lesion (5; 2.0%), atypical squamous cells, cannot exclude HSIL (2; 0.8%), and squamous cell carcinoma (2; 0.8%). Postmenopausal bleeding was the most frequent symptom (92; 36.8%), present in 23 (54.8%) women with abnormalities. The highest frequency occurred in women aged 46–50 years. Conclusion: Pap smear remains a cost-effective screening tool for perimenopausal and postmenopausal women. ASC-US was the most common abnormality, with peak prevalence in the 46–50-year age group. Regular screening, especially in women with postmenopausal bleeding, may enable early detection and timely management.