ISPUB.COM The Internet Journal of Pathology Volume 2 Number 1 1 of 5 Profile Of Cervical Smears Cytology In Western Region Of Saudi Arabia I Mansoor Citation I Mansoor. Profile Of Cervical Smears Cytology In Western Region Of Saudi Arabia. The Internet Journal of Pathology. 2001 Volume 2 Number 1. Abstract The aim of this study is to evaluate the importance of cervical PAP smears in order to detect the prevalence of abnormal Pap smear and types of abnormalities in Western region of Saudi Arabia. For this a retrospective study was designed to evaluate all consecutive cervical smears examined at King Abdul Aziz University Hospital from year 1984 to 2000. During this period a total of 22089 smears were reported. Among them there were 368 (1.66%) abnormal PAP smears out of total 22089 pap smears seen at our department during 15 years. Out of these 368 abnormal PAP smears there were 62 (16.8%, mean age 37) CIN I, 45 (12.2%, mean age 38.5) CIN II, 27 (7.3%, mean age 40.5) CIN III, 22 (6%, mean age 45.5) positive for malignant cells, 36 (9.8%, mean age 40.5) atypical endocervical cells, 88 (23.9%, mean age 39) atypical squamous cells, 9 (2.4%, mean age 40.5) squamous metaplasia with atypia, 26 (7.1%, mean age 45) squamous cell carcinoma, 6 (1.6%, mean age 36.5) repiarative atypia, 14 (3.8%, mean age 38.5) inflammatory atypia, 19 (5.2%, mean age 37.5) HPV changes, 2 (0.5%, mean age 35) herpes virus changes, 5 (1.4%, mean age 55) adenocarcinoma of endometrium and 7 (1.9%, mean age 43.5) adenocarcinoma of endocervix. The main conclusion derived from the study was that cervical screening programs are necessary nationwide to estimate the actual magnitude of cervical carcinoma and its precursor lesions. INTRODUCTION In 1941 Papanicolaou described cervical mass screening for sexually active women for early detection of cancer cervix and early pre-cancerous lesions. Until the early 1970s, approximately 75% to 80% of cervical cancer in the United States was invasive at the time of diagnosis. Today, about 78% of cervical cancer cases are diagnosed at the in-situ stage. Furthermore, both incidence and mortality for invasive cervical cancer have declined about 40% since the early 1970s. 1 Mortality began declining just before the Papanicolaou screening test became widely utilized, however, leaving a dilemma as to the relationship between the Pap test and reductions in cervical cancer mortality. Worldwide, cervical cancer is the second or third most common cancer among women (cervical cancer and colorectal cancer are virtually tied for second place after breast cancer). In some developing countries, it is the most common cancer. About 400,000 new cases are diagnosed each year, predominantly among the economically disadvantaged, in both developing and industrialized nations.1 In 1999, an estimated 12,800 cases of invasive cervical cancer are expected to occur in the United States, with about 4,500 women dying from this disease. In the United States, currently the highest age-adjusted incidence rate occurs among Vietnamese women (43 per 100,000), probably reflecting lack of prior screening. Incidence rates of 15 per 100,000 or higher also occur among Alaska Native, Korean, and Hispanic women. (For all U.S. women, the rate is about eight per 100,000). 2 , 3 In developing countries, because of widespread differences of the availability of screening programs and the prevalence of risk factors, there is marked difference in the relative frequency of cervical cancer. The highest incidence rate reported includes the sub-Saharan, Central and South America, Southeast Asia and Brazil. The lowest reported incidence rates are from Middle East and Jews living in Israel. Its incidence is low among Muslim and Jewish compared to other religious groups. But overall, the mortality has declined 45 percent between the periods 1972-74 and 1992-94, while incidence declined 43.3 percent from 1973 to 1995. While death rates for African Americans have declined more rapidly than for whites, the African American death rate (6.7 per 100,000) continues to be more than twice that of whites (2.5 per 100,000). The higher African American death rate is due to the high number of