Original Article

Opportunistic Cervical Cancer Screening Using Liquid-Based Cytology in a Gynaecology Outpatient Setting: A Cross-Sectional Study

Abstract

Background: Cervical cancer is a major public health issue, particularly in low- and middle-income countries. Early detection through effective screening methods is crucial for reducing morbidity and mortality. Opportunistic cervical cytology testing in outpatient settings plays an important role in the early identification of precancerous lesions.

Materials and Methods: This cross-sectional study aimed to evaluate the effectiveness of liquid-based cytology (LBC) in detecting precancerous lesions and cervical cancer in a defined population. One hundred women aged between 25 and 75 years were screened using LBC. Cytological specimens were processed and analyzed by experienced cytopathologists.

Results: The detection rate of precancerous lesions was 13% (n = 13), and cervical cancer was detected in 2% (n = 2) of patients. Most patients attending the outpatient department (OPD) were in the fourth decade of life (30–39 years; 37 cases, 37%), followed by the third decade (20–29 years; 23 cases, 23%). Of the patients diagnosed with low-grade squamous intraepithelial lesions (LSIL) or high-grade squamous intraepithelial lesions (HSIL), 72.7% (8 out of 11) were in the 51–70 years age group.

Conclusion: LBC demonstrated a detection rate of 13% for premalignant lesions and 2% for cervical cancer in this opportunistic screening population. The majority of LSIL/HSIL cases occurred in women aged 51–70 years, suggesting that older age groups may benefit from targeted screening efforts. These findings provide valuable insights into the performance of LBC in this setting and can inform the development of effective cervical cancer screening programs to reduce disease burden.

1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.
2. Bray F, Ren JS, Masuyer E, et al. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer. 2013;132(5):1133–45.
3. Mallath MK, Taylor DG, Badwe RA, et al. The growing burden of cancer in India: Epidemiology and social context. Lancet Oncol. 2014;15(6):e205–12.
4. International Agency for Research on Cancer. Latest world cancer statistics: Global cancer burden rises to 14.1 million new cases in 2012 [press release]. Lyon: IARC; 2013 Dec 12.
5. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Human papilloma viruses. IARC Monogr Eval Carcinog Risks Hum. 1995:64:1-378.
6. Bruni L, Barrionuevo-Rosas L, Albero G, et al. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in the World. Summary Report. 2017 19 April.
7. Cuzick J, Arbyn M, Sankaranarayanan R, et al. Overview of human papillomavirus-based and other novel options for cervical cancer screening in developed and developing countries. Vaccine. 2008;26(Suppl 10):K29–41.
8. Nanda K, McCrory DC, Myers ER, et al. Accuracy of the papanicolaou test in screening for and follow-up of cervical cytologic abnormalities: A systematic review. Ann Intern Med. 2000;132(10):810–9.
9. Fahey MT, Irwig L, Macaskill P. Meta-analysis of Pap test accuracy. Am J Epidemiol. 1995;141(7):680–9.
10. Rao TB. Methods of social classification. In: Rao TB, editor. Rao’s Sociology in Medicine. 1st ed. Guntur: Sree Graphics; 2002.
11. Conventional Pap smear and Liquid based cytology for cervical cancer screening- A Comparative study. Journal of cytology. 2007;24(4): 167-172.
12. Richart RM. Natural history of cervical intraepithelial neoplasia. Clin Obstet Gynecol. 1967;10(4):748-84.
13. Parkin DM, Pisani P, Ferlay J. Cancer incidence, mortality and prevalence worldwide. Version 1.0. IARC CancerBase No. 5. Lyon: IARC Press; 2001.
14. Sharma P, Rahi M, LaI P. A community based cervical cancer screening program among women of Delhi using camp approach. Indian J Community Med. 2010;35(1):86-8.
15. Almonte M, Ferreccio C, Winkler JL, et al. Cervical cancer screening by visual inspection, HPV testing, Liquid based and conventional cytology in Amazonian Peru. Int J Caner. 2007;121(4):796 – 802.
16. Hatch KD, Fu YS. Cervical and vaginal cancer. In: Berek JS, editor. Novak's Gynecology. 13th ed. Philadelphia: Lippincott Williams & Wilkins; 2002. PP: 471-93
17. Hu SY, Zhao XL, Zhang Y, et al. Interpretation of "WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention， second edition". Zhonghua Yi Xue Za Zhi. 2021;101(34):2653-2657.
18. https://www.who.int/news/item/06-07-2021-q-and-a-screening-and-treatment-cervical-pre-cancer-lesions-for-cervical-cancer-prevention?utm (accessed on 22 Dec 2025).
19. https://www.acog.org/clinical/clinicalguidance/practice-advisory/articles/2021/04/updated-cervical-cancer-screening-guidelines?utm (accessed on 22 Dec 2025).
20. Ramamoorthy T, Sathishkumar K, Das P, et al. Epidemiology of human papillomavirus related cancers in India: findings from the National Cancer Registry Programme. Ecancermedicalscience. 2022;16:1444.
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IssueVol 20 No 2 (2026) QRcode
SectionOriginal Article(s)
Keywords
Cervical cancer; Premalignant lesion; LBC; PAP smear; Cancer screening
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How to Cite
1.
Das K, Suryarao P. Opportunistic Cervical Cancer Screening Using Liquid-Based Cytology in a Gynaecology Outpatient Setting: A Cross-Sectional Study. Int J Hematol Oncol Stem Cell Res. 2026;20(2):144-151.