The Study of Specimen Adequacy according to the Bethesda System 2001 Classification in Conventional Pap Smears from Patients Referred to Beheshti Hospital, Isfahan, Iran

Pap smear is an easy and cost-effective screening method for cervical carcinoma and its precursors. The Bethesda system 2001 for reporting cervicovaginal cytology provides valuable information about specimen adequacy. In the present study, we investigated the status of specimen adequacy in Pap smears taken from women who had referred to Beheshti Hospital in Isfahan, Iran. In this cross-sectional study, all women with Pap smears in Beheshti Hospital in a 6-month period were evaluated. Exclusion criteria were the history of previous cervical cone biopsy or total hysterectomy. The specimens were studied by the investigators using a two-headed microscope and their adequacy was classified according to the Bethesda system 2001. Overall, 99.1% of the 1420 investigated specimens were satisfactory. Moreover, 60% of partially obscured and 46.2% of unsatisfactory specimens had been obscured by excessive thickness. The results of this study showed that a considerable percentage of Pap tests are satisfactory for evaluation. Excessive thickness was found to be the most frequent obscuring factor in this study. Since this obscuring factor happens during smear preparation, training is helpful in reducing its frequency.