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Prevalence of Abnormal Pap Smears among Sample of Iraqi Women Attending Al Elweiya Cervical Screening Unit in Baghdad

Introduction: Cervical cancer is the13th leading cause of female cancers in Iraq. Pap smear is a simple, cost-effective screening test to detect abnormalities that may lead to cancer. The current study aims to determine the prevalence of abnormal pap smears and to find the association between socio-demographic risk factors and abnormal pap smear results. 
 
Patients and methods: A cross sectional study was conducted in Al Elweiya Teaching Hospital in Baghdad for a period of nine months; from first of January till the first of October 2019 where all female patients visiting the cervical screening unit during the study period were included, total sample size was(401). Smears were collected by Ayre's spatula and slides were evaluated at the cytology lab according to Bethesda Scoring System. Chi square test used to illustrate associations between pap smear results and socio-demographic features. Binary logistic regression was applied for the significant variables. In all statistical analyses, a P value < 0.05 was considered significant. 
 
Results: More than two third of the sample (271;67.7%) had normal pap smear results. While the remaining (130;32.3%) had abnormal pap smears. Vaginal discharge (38.4%), post coital bleeding (18.5%) and irregular bleeding (13.2%) were the main patients complaints. Only one case was diagnosed with carcinoma of cervix. Women ≥40 years of age and smokers showed a highly significant association with abnormal pap smears in which(p=0.002) for both. Being ≥40 years were two times more likely to have abnormal pap smears [p=0.002; OR=2.006; CI 95%(1.29-3.09)], while being smokers increased the odds of having abnormal pap smears three times [p=0.001; OR=3.063; CI 95% (1.53-6.10)] 
 
Conclusions and Recommendations: About one third of the sample size had abnormal pap smear results, Women ≥40 years and smokers showed a highly significant association with abnormal pap smear results. There is a need for activation and implementation of an effective cervical cancer screening program and increase the awareness and health promotion about its risk factors.