The Importance of Post Coital Bleeding in Countries with Low Level Cervical Cancer Screening

This study aimed to examine the extent to which postcoital bleeding (PCB) can be a predictive factor for cervical cancer.

In this observational study we selected and evaluated 280 females with PCB referred to Kowsar Hospital of Qazvin, Iran from 2017 to 2019.

Among the 189 patients diagnosed as normal in their Pap smear results, one patient had cancer in her biopsy results. A closer look at the biopsy results of the patients showed 45 patients as normal, 64 patients with cervical infection, 31 patients with polyp cervix, 45 patients with cervical intraepithelial neoplasia 1 (CIN 1), and one patients with squamous cell carcinoma (SCC). Among 63 patients diagnosed with atypical squamous cells of undetermined significance (ASCUS), three showed CIN 2 and CIN 3 in their biopsies. Furthermore, out of 21 patients with low-grade squamous intraepithelial lesion (LSIL), three patients had CIN 2 and CIN 3, one patient had carcinoma, and one had SCC. In addition, all of the patients with high-grade squamous intraepithelial lesion (HGSIL) were diagnosed with CIN 2, CIN 3, and SCC.

Because of the higher rate of cervical cancer in women with PCB and inconsistent screening programs in developing countries, it is essential to carefully consider the symptoms of PCB despite having a normal Pap smear.