Cervical cytology screening in a sexually transmitted diseases clinic for the first time in Sri Lanka

Abstract

A prospective study of cervical cytology was carried out on 350 consecutive female patients attending the central venereal diseases clinic (CVDC) in Colombo, Sri Lanka. The main objective was to assess the proportion of abnormal cervical smears to emphasise the need to introduce routine cervical cytology screening in the sexually transmitted diseases (STD) clinics in Sri Lanka. Data about each woman's age, sexual history, method of contraception, number of pregnancies, genital infections, and previous cervical smears were collected to compare the findings in patients with normal smears with findings in those with abnormal smears. Smears reported as showing koilocytic atypia, dyskaryosis, carcinoma in situ, or invasive carcinoma were considered to be abnormal. Forty seven (13.4%) women in the study sample had abnormal smears, and 32 of these were aged under 35. None of the 350 patients had had a cervical smear taken previously. Women who had had five or more pregnancies, compared with those who had had four or fewer pregnancies, and women with trichomoniasis, compared with no genital infection, had significantly higher incidences of abnormal than normal smears. Higher proportions of abnormal than normal smears were also found in women whose sexual partners had been surgically sterilised. These findings suggest a serious need for cervical cytology screening in STD clinics.