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ORIGINAL ARTICLE: EPIDEMIOLOGY OF CANCER AND CANCER SCREENING
Year : 2020  |  Volume : 9  |  Issue : 1  |  Page : 13-16

Reliability of conventional Papanicolaou smear in diagnosing bacterial vaginosis among women with clinical genital infection


1 Department of Preventive Oncology, Tata Memorial Centre, Affliliated to Homi Bhabha National Institute, Mumbai, Maharashtra, India
2 Department of Microbiology, R. N. Cooper General Hospital, Tata Memorial Hospital, Mumbai, Maharashtra, India
3 Department of Cytopathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
4 Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
5 Department of Health Disparities Research, Division of Cancer Prevention and Population Science, MD Anderson Cancer Centre, Houston, USA

Correspondence Address:
Dr. Sharmila Anil Pimple
Department of Preventive Oncology, Tata Memorial Centre, Affliliated to Homi Bhabha National Institute, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sajc.sajc_421_18

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Objective: Bacterial vaginosis (BV) is a common reproductive tract infection (RTI) reported among Indian women. BV can influence the persistence of high-risk oncogenic human papillomavirus, a causative factor for cervical cancer. BV and cervical cancer are major public health issues in a developing country like India. It becomes important for a resource-constrained country like India with poor healthcare access to implement control measures to screen and treat RTI in an attempt to prevent the risk for cervical cancer. Papanicolaou (Pap) smear is an established screening tool for cervical cancer and the diagnosis of RTIs, forms a part of its evaluation. The present study explores the validity of conventional Pap smear in diagnosing BV. Methodology: Pap smear and Gram stain smear were collected for 254 women with clinically evident cervicitis/cervicovaginitis (genital infection). Using the Nugent score on Gram stain as a gold standard, we determined the sensitivity and specificity of Pap smear to diagnose BV. Results: The overall prevalence of BV in the study population was 44% using the Nugent score. Pap smear showed sensitivity and specificity of 70.9%. (CI- 61.5% - 79.2%) and 56.8% (CI – 48.2%–65.2%), respectively. The positive predictive value of Pap smear to diagnose BV was 56.5% (CI – 47.8%–64.9%), and the negative predictive value was 71.2% (CI – 61.8%–79.4%). Conclusion: In the present study, conventional Pap smear demonstrates good accuracy to detect BV. Pap testing for cervical cancer screening can additionally serve as an effective screening tool for diagnosing BV among women with genital infection in healthcare settings.


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