Vol. 8, Issue 4, Part A (2025)

Cervical carcinoma continues to pose a significant public health concern in developing countries due to inadequate screening and delayed diagnosis. Cervical cytology remains the cornerstone of screening programs for identifying premalignant epithelial changes, although variability in interpretation necessitates histopathological confirmation. The present study was undertaken to assess the diagnostic performance of Pap smear cytology by correlating cytological findings with histopathological outcomes. This retrospective observational study included 149 women who underwent cervical cytology followed by histopathological evaluation of cervical biopsy or hysterectomy specimens within a three-month interval at a tertiary care center. Cytological interpretations were reported according to The Bethesda System, and histopathology was regarded as the reference standard. Concordance between cytology and histopathology, along with diagnostic performance parameters, was analyzed. Most patients belonged to the 31–40-year age group (38.9%), and vaginal discharge (34.9%) was the most common presenting complaint. Negative for intraepithelial lesion or malignancy (NILM) was observed in 42.9% of smears. Among epithelial abnormalities, ASC-US and LSIL were the most frequent, accounting for 14 cases each. Histopathological examination predominantly revealed benign lesions, with chronic cervicitis seen in 55.7% of cases. Premalignant lesions were identified as CIN 1 in 7 cases and CIN 2 in 6 cases, while 4 cases showed malignancy. Cytology–histopathology concordance was achieved in 118 cases (79.2%). The Pap smear demonstrated a sensitivity of 88.2%, specificity of 78.0%, and diagnostic accuracy of 79.2% for detecting cervical epithelial lesions. Cervical cytology serves as an effective, economical screening modality, particularly in resource-limited settings. However, histopathological evaluation remains essential for definitive diagnosis, especially in abnormal or symptomatic cases. The addition of HPV testing may further improve early detection and enhance cervical cancer prevention strategies.