The value of Pap smear in detecting cervical neoplasia compared with histopathologic findings in patients referred to Taleghani Hospital, Tehran 2007-2009

Although the Pap smear screening test has showed a great success in early diagnosis of cervical cancer in different countries over the past 60 years, cervical cancer has remained the fifth most common cancer among Iranian women. The diagnostic value of Pap smears which are done in health centers around the country compared with international standards for cervical cancer screening requires further consideration. The purpose of this study was to compare Pap test’s findings with colposcopic biopsies as the gold standard. In this cross-sectional study, all non-pregnant women attended to Taleghani hospital gynecology clinic between 2007 and 2009 for routine Pap smear and were volunteer to participate in this research, and based on clinical findings as well as colposcopist’s opinion had an indication for colposcopy, were included. Eligible women had a Pap test as well as colposcopy and cervical biopsy thereafter. Sensitivity, specificity, positive and negative predictive value (PPV & NPV) of Pap test was calculated compared with cervical biopsy as the gold standard. Overall, %67 of women had abnormal biopsy (mostly HPV appearance), whereas only %21 of Pap smear results indicated abnormal cervical screening test results. The sensitivity, specificity, PPV, and NPV of Pap smear for detecting cervical neoplasia in our study was %23.9, %84.8, %76.2, and %35.4, respectively. ‍ The sensitivity of Pap smear was less than other reports. It needs more quality control, including sampling, sample preparation and interpretation in this center. Studies with more samples in other hospitals and particularly in different health care centers in Iran are highly recommended.