CYTOLOGY AND CLINICAL SPECTRUM OF SEXUALLY TRASMITTED INFECTIONS IN LEBANESE WOMEN ARE REVEALED BY PAP SMEAR: A CROSS-SELECTION STUDY FROM 2002-2006

OBJECTIVE: To study the cytology profile of cervical smears and the respective prevalence and incidence of certain cervico-vaginal infections detectable by routine Pap smear cytology in Lebanese women from 2002 to 2006. METHODS: Pap smear cytology results were compiled from the archives of the “Institut National de Pathologie” for the period extending from 2002 until 2006. This study covered 118,230 cervical specimens obtained from Lebanese women attending clinics and hospitals in all the five districts of Lebanon; prevalence and incidence rates for infections detectable by routine Pap smear examination were determined. RESULTS: A rise in prevalence of these infections by 2.1% (2,555) from 2002 to 2006 was revealed. A doubling of Pap smears showing “HPV-associated changes” was detected (1.4% in in 2002 to 2.9% in 2006) and a simultaneous almost 7-fold increase of Atypical Squamous Cells of Undetermined Significance (ASCUS) cytology was detected during this period; the rise in ASCUS cytology was age-dependent. Moreover, a 60% increase in prevalence of bacterial vaginosis (2.3% in 2002 to 3.7% in 2006) and a more than 3-fold decline in Trichomonas vaginalis infection (1% in 2002 to 0.3% in 2006) were also noted in this population during this period. CONCLUSION: An increase in the prevalence and incidence of cervico-vaginal infections detectable by Pap smear cytology in Lebanese women was revealed from 2002 to 2006. Such changes could point to recent modifications of sexual and health behaviors in the Lebanese community.