Background:
Cancer of the cervix uteri is the fifth most common cancer in Kuwaiti females (4.6%) with age standardized incidence rate of 6.8/100,000. The relatively lower prevalence of cervical lesions and cancer may be related to sexual behaviour under the religious roles and the practice of circumcision .
Aim:
The aim of this study was to document the changing trends in epithelial cell abnormalities (ECA) in cervical cytology in Mubarak Al-Kabeer Hospital (MAKH) Kuwait.
Methods:
During a 21-year period ( 1992 – 2012) 140,404 cervical smears were studied in MAKH of which 135,766 were found satisfactory for reporting. Comparison of the ECA was done between three periods of seven years each.In the third period (2006-2012)Thinprep smears were examined.
Results:
Satisfactory rates were better in the third period. Atypical squamous cells (ASCUS) were seen in 3212 cases (2.37%), atypical glandular cells (AGC) in 1092 cases ( 0.80%), low grade squamous intraepithelial lesions including human papilloma virus changes (LSIL) in 294 cases (0.22%) cases, and carcinoma in 118 cases ( 0.09%) . Significant increase (p<0.001) in the proportion of satisfactory smears, ASCUS and AGUS cases was noticed in the second and third period, compared to first. No major significant increase was observed among LSIL and HSIL cases during these years (p>0.05). In carcinoma cases, an increase was observed between first and second period but again showed a significant decline (p<0.014) in the later years.
Conclusions:
The data shows that there was an increase in ASCUS and AGUS but no significant change in LSIL, HSIL and carcinoma over the years.LSIL seemed to be occurring at an early age, thereby making it essential to institute a screening program with high participation from young women.