UICC World Cancer Congress 2006

Objective: Detection of precancerous lesions and cancer by cervical PAP smears in patients from Georgia. Methods: We retrospectively analysed the results of 4188 PAP smears taken from women with vaginal discharge. Results: There were 4128 (98.6%) abnormal smears. Normal smears were found in 20 (0.5%) patients, unsatisfactory smears in 40 (0.9%) patients. Out of 4128 abnormal Pap smears there were 3140 (76.1%) Trichomonas vaginalis infection, 2624 (63.6%) candidiasis, 312 (7.6%) bacterial vaginosis, 28 (0.7%) actinomyces, 68 (1.6%) doderlein cytolysis, 252 (6.1%) HSV infection, 30 (0.7%) intrauterine contraceptive device-induced changes, 44 (1.1%) glandular cells status posthysterectomy, 376 (9.1%) atrophic changes, 524 (12.7%) HPV infection, 708 (17.2%) CIN 1, 408 (9.9%) CIN 2, 88 (2.1%) CIN 3, 20 (0.5%) SCC in situ, 16 (0.4%) SCC, 264 (6,4%) atypical endocervical glandular cells, 304 (7,4%) endocervical glandular hyperplasia, 824 (20%) reserve cell hyperplasia, 144 (3.5%) squamous metaplasia, 68 (1.6%) tubal metaplasia, 188 (4.6%) microglandular hyperplasia, 60 (1.2%) Arias-Stella reaction, 10 (0.2%) endocervical adenocarcinoma. The randomized examination of cervical PAP smears in women with vaginal discharge showed that cervical infections, dysplasias and invasive cervical carcinoma are much more common in Georgia compared to the Western countries. The possible reason is the absence of cervical screening program, low social-economic status, lack of awareness of cancer prevention by PAP smears. These results indicate that cervical screening program is necessary to estimate the actual magnitude of cervical carcinoma and its precursor lesions. Furthermore, it is possible to examine 35-50 years old women in low resource countries like Georgia.