Introduction: Uterine cervical screening by Papanicoloau method using cervical smears is an important diagnostic tool in the field of public health. Procedure wise uterine cervical screening is an easy, cost effective mean to detect the premalignant and malignant lesions of Uterine Cervix at the earliest in the community at large. Among the uterine cervical lesions, the cervical intra-epithelial neoplasia (CIN) and cervical cancer are still remain the major health problems for women during the reproductive period in developing and developed countries. Aim: To study the spectrum and frequencies of cytomorphological changes that encountered in Cervical smears by Papanicoloau method in accordance with Bethesda system of classification 2014. Material & Methods: This is a retrospective study comprising of analysis of 4634 cervical PAP smears examined as a part of hospital based screening programme during the period from January 2015 to December 2018 in the Cytology division of Pathology department, at Shridevi Institute of Medical Sciences and Research hospital, Tumkur, a tertiary care hospital. However the case sheets, pathological slides and reports were reviewed. Results: The overall frequency of epithelial cell abnormalities in the present study is 5.2%. The atypical squamous cell of undetermined significance (ASC-US), Low-grade squamous intraepithelial lesion (LSIL), High-grade squamous intraepithelial lesions (HSIL) and carcinoma cervix were 0.8%, 3.1%, 1.2% and 0.1% respectively. Discussion: Uterine cervical cancer is the fourth leading cause of death among females in the world and it is the second commonest in India. The cytomorphological changes mainly includes atypical squamous cell of undetermined significance (ASC-US), Low-grade squamous intraepithelial lesion (LSIL), High-grade squamous intraepithelial lesions (HSIL) and carcinoma cervix. Conclusion: Pap smear screening is a simple, safe, useful diagnostic tool for early diagnosis and to detect cervical intraepithelial lesions at the earliest. The aim of cervical cancer screening programme is to detect the precursor cervical lesions and not frank cancer cervix. Hence it is desirable to promote easy pap screening test before 40 years of age. As the resources concerning to cytology based activities are less in Indian settings, the WHO recommendation of once in a life time cervical screening between 35 and 40 years of age is more appropriate to identify the high risk women for carcinoma cervix.

Keywords: Bethesda system; Epithelial cell abnormalities; ASCUS; LSIL; HSIL.