Practitioner seniority as a predictor of pap smear quality in Barat Daya District, Penang

Haslinda Sumery, Siti Hazwani Zainal Azman, Umi Kalsum Ibrahim, Norliza Mohd Razali, Habibah Osman, Noorliaza Shahidan, Noor Hidayah Yusof, Ahmad Hanis Ahmad Shushami


The quality of pap smear determined by the specimen adequacy of cervical smears. It plays an important role to detect changes in the cervix particularly the transformation zone (TZ). This study aimed to determine factors associated with poor pap smear quality in Barat Daya District, Penang. This is a cross-sectional study of 276 randomly selected specimens of woman who underwent pap smear test in all government health clinics in Barat Daya District, Penang between January until June 2019. Study proforma was based on cytological report issued by Pathology Department, Penang Hospital and staff records in Nursing Unit, Barat Daya District Health Office. 30.1% has poor smear quality. Women who are menopause are twice the risk to have poor smear quality [Adjusted OR (95% CI): 2.34(1.14, 4.84), p<0.05]. Using conventional method are also had twice the risk of having poor smear quality [Adjusted OR (95% CI): 2.32 (1.14, 4.63), p<0.05], and there were 40% increase in risk of getting poor smear with every increment of 10 years duration of service [Adjusted OR (95%CI): 1.04 (1.0,1.09), P<0.05]. There is a need for credential and privileging for staff nurses to improve smear quality since patient’s menopausal status cannot be controlled. Using Liquid-based method is also recommended to improve the quality of pap smear result


Papanicolaou (pap) smear, transformation zone, endocervical cell, specimen adequacy

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