Introduction: Almost one-fourth of the global cervical cancer burden is in India. There is an enormous opportunity for screening with the prospect of detection of cancer at the preclinical stage and hence, cervical cancer control programs become important. Aims and Objectives: To correlate abnormal Pap smears with colposcopic findings, HPV testing, FHACT and cervical biopsy findings. Materials and Methods: The present study was a prospective observational study carried out at Kamineni Hospital, LB Nagar, Hyderabad, over a period of two years. The study group consisted of 150 women with abnormal cytology report (ASCUS and above) in whom colposcopy guided biopsy, HPV test and FHACT test were done and results were correlated. Observations and Results: The prevalence of abnormal Pap smears was 2.91%. In the 150 patients with abnormal pap smears, 63.3% cases, showed normal per speculum findings. Pap smear test had a very low sensitivity of 34.29% and high specificity of 95.65%, PPV of 92.31% and NPV of 48.89%. Colposcopy had a sensitivity of 60% and specificity of 73.91 %, PPV of 77.78%, NPV of 54.84%. HPV test was positive in 40% cases. Conclusions: It is recommended that colposcopy when available, should be used as the next step in evaluation of women with ASCUS/ASCH/LSIL instead of following them up with repeat smears. The FISH-based HPV-associated cancer test can be used as a secondary screening assay, along with HPV subtyping to assist in patient management decisions.

Keywords: Pap Smears; Colposcopic Guided Biopsy; FISH; HPV Subtyping; FHACT