Objectives: Cervical cancer mortality has decreased 75% over five decades, largely attributable to the introduction of Papanicolau (Pap) smear screening in 1940s. Although cervical smear interpretation is highly successful, reliability of the cytological diagnosis depends on the technique of provider, accuracy of selection of the sampling site and of application of the technique.

Materials and Methods: In the present study 1322 smears which were diagnosed according to Bethesda system in Fırat University Medical Faculty Pathology Department were evaluated to determine limited adequacy and inadequacy rates and reason retrospectively.

Results: Of the total 1322 Pap smears, 844 (63.8%) were adequate, 383 (29%) partially adequate and 95 (7.2%) were inadequate. The most frequent reason was the absence of endocervical/metaplastic cells (n:159, 41.5%) in cases with limited adequacy and obscuring inflammation (n:37, 38.9%) in inadequate cases. Epithelial cell abnormality was detected in 30 smears (2.2%). Consistent with the previous findings epithelial cell abnormality was higher in the presence of endocervical/metaplastic cell (n:25, 83.3%).

Conclusion: The designation of the adequate/inadequate specimen collection reasons, especially absence of endocervical/metaplastic cell may help the physician to re-evaluate the specimen collection techniques and increase in smear quality. In addition the education of Pap smear taking staff, application of suitable technique and increament of expertise will be solution to increase adequacy ratio. ©2006, Fırat Üniversitesi, Tıp Fakültesi