Abstract

BACKGROUND:
Cervical cancer develops slowly, raising the possibility of early recognition of pre-neoplastic lesions using Papanicolaou test and consequently avoiding deaths. Cervical screening system seeks to identify females who have an epithelial abnormality that could; if untreated, take the lead to the progress of cervical carcinoma. Extremely applied test for cervical carcinoma screening is cervical cytology which is effective in decreasing the occurrence of cervical cancer deaths by 70% since 1950.
OBJECTIVE:
To assess cervical pap smear from a sample of Iraqi patients according to The Bethesda System (TBS) 2014 and to study the relation of different categories of TBS with cinicopathological parameters include (patients age, clinical presentation, parity, and lower female genital tract infection).
MATERIALS AND METHOD:
A cross sectional study was conducted in the Department of Pathology/ Collage of Medicine/                    Al-Nahrain University, Baghdad, Iraq (For a period from January  2021 to January 2022). Cases were collected from Medical Consultant Office/ College of Medicine/ Al- Nahrain University (For a period from May 2017 to December 2020). There were 209 patients referred at that period. The data that were analyzed for patients according to five general factors: (age of the patient, clinical presentation, parity, types of lower female genital tract infection, microscopic examination and final diagnosis according to The Bethesda System 2014).
RESULTS:
The mean age was 40 ± 9.95 years .According to The Bethesda System 2014: Negative for intraepithelial lesion or malignancy was (57 cases 27%), Atypical squamous cells of undetermined significance composed (4 cases 2%), Low grade squamous intraepithelial lesion was (96 cases 46%), High grade squamous intraepithelial lesion was (51 cases 24%), Atypical glandular of undetermined significance was (1 case 0.5%). There was significant correlation between The Bethesda System 2014 categories and age P value = 0.014. There was no correlation with clinical presentation, number of parities and types of lower genital infections, P value was (0.806, 0.277, 0.063) respectively.
CONCLUSION:
The most frequent category of The Bethesda system 2014 categories in this cross – section study was low grade squamous intraepithelial lesion (46%), High grade of cervical intraepithelial lesion is significantly associated with older age group and there was no significant association of The Bethesda System 2014 categories and clinical presentation, number of parities and types of cervico-vaginal infections.