Colposcopy Assessment of Persistent Inflammatory Changes in Cervical Cytology

Introduction: It has been reported that inflammation on Pap smear is quite common. Chronic inflammation, whether specific or nonspecific, has been linked to cancer development and is considered one of the factors responsible for carcinogenesis. Women who have persistent inflammation on Pap smear should undergo further evaluation and treatment. Objective: This research aims to study the effectiveness of colposcopy in terms of assessing persistent inflammatory changes in cervical cytology e.g., Pap smear. Methods: Between January 2021 and January 2024, this prospective study was carried out in the Department of Obstetrics and Gynecology at Holy Family Red Crescent Medical College Hospital in Dhaka, Bangladesh. The study involved screening 320 women with Pap smear tests. Women who received an inflammatory Pap smear report, aged between 20 years and 65 years, were included in the study. Both partners were treated and advised to use barrier contraception for the same duration. These women were asked to come back after six weeks for Pap smear and VIA follow-up tests. Patients with persistent inflammation, even if VIA negative, were then referred for colposcopy and guided biopsy. Results: Out of a group of 320 women, 234 (73.13%) had an initial Pap smear report suggesting inflammation. Out of all the women who were examined, 21% had normal colposcopic findings while 79% had abnormal findings. After a histopathological examination (HPE), it was found that 69% of women had cervical intraepithelial neoplasia (CIN) 1, 23% had CIN II, 6% had CIN III, and 3% had SCC. Additionally, 25% of women tested positive for HPV DNA and 75% of women tested negative for HPV DNA. Conclusion: It is important to repeat an inflammatory smear test because persistent inflammation can cause dysplasia. Patients with persistent inflammatory Pap smears despite undergoing treatment show changes on Colposcopic directed biopsies. In addition to a Pap smear, VIA (Visual Inspection with Acetic Acid) ......