Cervical cytology in an urban population in Lagos, Nigeria.

Eight hundred and eighty-four consecutive women had cervical smears in a clinic in Lagos, Nigeria between September 1998 and 31 August 1999. Mean age was 36.6 - 11.6 years (range 16-81 years); 93.7% were first-time screening. Three hundred and twenty-five (36.5%) smears were normal, inflammatory smears 52.7%, mild dyskaryosis 2.4%, moderate dyskaryosis 1.5%, severe dyskaryosis 0.3% and probable malignancy (malignant cells) 0.8%. Abnormal smears were higher in symptomatic cases compared with asymptomatic cases (chi2=15.3, P< 0.01); 6.1% and 2.1% of symptomatic cases had dyskaryosis and carcinoma, respectively, compared with 3.4% and 0.1% for asymptomatic cases. In postcoital bleeding 9.3% and 1.9% had dyskaryosis and carcinoma, respectively. Fifty-six of 62 cases of cervical erosion had abnormal smears. In postmenopausal bleeding 13.0% and 4.3% had dyskaryosis and carcinoma, respectively. Prevalence of abnormal cervical smears is high in women who have genital tract disease. In places with no national screening programmes every effort should be made to screen such women.