Practitioner seniority as a predictor of pap smear quality in Barat Daya District, Penang
Keywords:
Papanicolaou (pap) smear, transformation zone, endocervical cell, specimen adequacyAbstract
The quality of pap smear determined by the specimen adequacy of cervical smears. It plays an important role to detect changes in the cervix particularly the transformation zone (TZ). This study aimed to determine factors associated with poor pap smear quality in Barat Daya District, Penang. This is a cross-sectional study of 276 randomly selected specimens of woman who underwent pap smear test in all government health clinics in Barat Daya District, Penang between January until June 2019. Study proforma was based on cytological report issued by Pathology Department, Penang Hospital and staff records in Nursing Unit, Barat Daya District Health Office. 30.1% has poor smear quality. Women who are menopause are twice the risk to have poor smear quality [Adjusted OR (95% CI): 2.34(1.14, 4.84), p<0.05]. Using conventional method are also had twice the risk of having poor smear quality [Adjusted OR (95% CI): 2.32 (1.14, 4.63), p<0.05], and there were 40% increase in risk of getting poor smear with every increment of 10 years duration of service [Adjusted OR (95%CI): 1.04 (1.0,1.09), P<0.05]. There is a need for credential and privileging for staff nurses to improve smear quality since patient’s menopausal status cannot be controlled. Using Liquid-based method is also recommended to improve the quality of pap smear result
References
Bruni L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Malaysia. Summary Report 17 June 2019. [21/1/2020]
Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2018). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/today
Wright Jr, T. C., Stoler, M. H., Behrens, C. M., Sharma, A., Sharma, K. & Apple, R. (2014). Interlaboratory variation in the performance of liquid-based cytology: Insights from the ATHENA trial. International Journal of Cancer, 134(8), 1835-1843. doi: 10.1002/ijc.28514
Pap Smear (Pap Test): Reasons, Procedure & Results. Retrieved from: https://www.healthline.com › health › pap-smear (Accessed: 19/9/2019)
Elumir-Tanner, Lizette et al. “Management of Papanicolaou test results that lack endocervical cells.†CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne vol. 183,5 (2011): 563-8. doi:10.1503/cmaj.101156
Zhao, L., Wentzensen, N., Zhang, R.R. (2014). Factors associated with reduced accuracy in Papanicolaou tests for patients with invasive cervical cancer. Cancer Cytopathol, 122, 694-701
Pejabat Kesihatan Daerah Barat Daya (2019). Laporan Kejururawatan, Kementerian Kesihatan Malaysia
Najib, M. (2015). Sample Size Calculator for Estimation of a Single Proportion, Unit of Biostatistics & Research Methodology, School of Medical Sciences, Universiti Sains Malaysia Kubang Kerian Kelantan.
Mohamed A.M., Paul G.C., Desmond P.B., et. al. (2001). Cervical intraepithelial neoplasia in postmenopausal women: difficulties in cytology, colposcopy and treatment. The Obstetrician & Gynaecologist, 3(1),8-1
Noor, N.M. and Sultan, H.M., 2008. Pap Smear Screening in Bachok, Kelantan from January to June 2005. International Medical Journal, 15(3).
Davey, E., Barratt, A., Irwig, L., Chan, S.F., Macaskill, P., Mannes, P. and Saville, A.M., 2006. Effect of study design and quality on unsatisfactory rates, cytology classifications, and accuracy in liquid-based versus conventional cervical cytology: a systematic review. The Lancet, 367(9505), pp.122-132.
Castle, P.E., Bulten, J., Confortini, M., Klinkhamer, P., Pellegrini, A., Siebers, A.G., Ronco, G. and Arbyn, M., 2010. Ageâ€specific patterns of unsatisfactory results for conventional Pap smears and liquidâ€based cytology: data from two randomised clinical trials. BJOG: An International Journal of Obstetrics & Gynaecology, 117(9), pp.1067-1073.
Demir B, Haberal A, Ozturkoğlu E, Dündar B, Baskan B, Sobacı E, Özgül N. Pap smear screening among the postmenopausal women. Gynecology Obstetrics & Reproductive Medicine. 2010 Dec 11;16(3):168-72.
Lundberg G.D. (1989b). Quality assurance in cervical cytology. The Papanicolaou smear. JAMA, 262, 1672-1679.
Srikanth J, Upadhya KG, Kumar P. Awareness of cervical and breast cancer among women attending OBG out-patient department of a medical college hospital, Bangalore. Int J Community Med Public Health. 2018 May;5:2104-8.
Ja’afar SM, Awang H, Ibrahim RMR, Yasin Z, Dollah Z. Absence of Endocervical/Transformation Zone Component in Cervical Papanicolaou Smears in Northeastern Region of Peninsular Malaysia: Prevalence and Risk Factors. International Journal of Human and Health Sciences (IJHHS). 2020;4(3):178-8
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