Assessment of Cervical Cytological Data in Albanian Females

According to the 2011 Census-Al, the population in Albania was estimated at 2.8 million, the average age of the population increased from 30.6 years in 2001 to 35.3 in 2011, with 48.9%. Female, and female age-group 20-60 years are estimated 864,583. The burden of communicable diseases is decreasing in general terms, but some infections as HIV/AIDS are increasing. Prevalence of HIV/AIDS is low, although the incidence of HIV is increasing. About 90 percent of HIV infections occurred as a result of sexual contact. Most cases of HIV in Albania have been diagnosed among women and men age 25-44.


Introduction
According to the 2011 Census-Al, the population in Albania was estimated at 2.8 million, the average age of the population increased from 30.6 years in 2001 to 35.3 in 2011, with 48.9%.Female, and female age-group 20-60 years are estimated 864,583.The burden of communicable diseases is decreasing in general terms, but some infections as HIV/AIDS are increasing.Prevalence of HIV/AIDS is low, although the incidence of HIV is increasing.About 90 percent of HIV infections occurred as a result of sexual contact.Most cases of HIV in Albania have been diagnosed among women and men age 25-44.cardiovascular diseases, cancer and external causes of death are increasing.In Albania, cervical and breast cancer are most frequented cancer among women of all ages and is the leading cause of cancer death among women (Bray et al., 2012).Currently, cancer accounts 16% of all deaths in Albania and breast cancer is the second leading cause of death in women aged 35-54 after stomach cancer.
Because no national cancer registry has been established in Albania yet, the data on the incidence and mortality rates for cervical cancer more likely represent (Ferlaya among the female population of 1.6 million, with an estimated 124 cases of cervical cancer, the crude incidence rate was 7.8/100,000 (world age-standardized incidence
In addition, despite the fact that cervical cancer represents the second most common cancer among women age 15 to 44, and most cancers are diagnosed at stage III to IV, only 8% of women that have ever had a routine gynecological exam also had a Pap smear (Morris et al., 2005).
There is no organized cervical cancer screening program in Albania.The Pap smear is offered in some gynecological-obstetrical centers and private clinics in prevalence of cervical cytological abnormalities in the Albanian population and the detection rate of epithelial abnormalities by CC.

Materials and Methods
A total number of 5416 conventional pap smear tests were done between January 2009 and January 2012 at Geraldine", located in the capital of the country, Tirana ethical comity approval has been taken for the study.Conventional samples (CC) were collected and smeared Pathology, part of the maternity.The results were assessed evaluation" based on terminology from the Bethesda, squamous cells, cannot exclude high-grade lesions analyses were performed by SPSS software vs. 20.0.

Results
A total number of 5416 samples were retrospectively analyzed Table 1.The mean age of the participants was 42.8 years (13 to 83 years).The age of the patients was of the smear results are listed in Table 1.
These data show that the unsatisfactory rate for the CC technique was 0.9% (n=50).The main causes for CC inadequacy were sample obscured by red blood cells and (94.31%) of the samples.The most common reported benign result was chronic cervicitis with 2441 cases (45.1% of all samples).
A total number of 258 (4.8%) cases had epithelial abnormalities.The numbers and rates of epithelial n
The patients ( Incidence rates varied according to IARC data researches, with the lowest ASR observed in Finland (ASR=8 per 100,000) and the highest in Uganda (ASR=104).Currently, the incidence rates in developed countries were generally low, with age-standardized rates less than 14.5/100 000.Also, very low rates are observed the lowest recorded rate is 0.4/100,000 in Ardabil, northwest Iran (Abdullah, 2007).In Balkan countries, the standardized incidence rate varied from 7.2/105 in Greece to more than 20.0/105 in Romania and Serbia and Montenegro (Arbyn et al., 2007).
In the present study, the detection rates for ASCUS and over lesions were found to be 4.8% (n=258).The low prevalence of abnormal smears in Albania, compared with data from other populations, could be due to the health awareness in the women, and that poor people in Albania often avoid hospitalization (Morris et al., 2002).
The varying period and cohort patterns in ICC trends across countries can be largely attributed to two i) the existence, duration, and quality ii) changes in ICC risk factors, notably sexual behaviour and, hence, the probability of HPV exposure, affecting Hank et al., 2013).A long-term increase in prevalence of HPV is presumably the main reason for the rapid increase in cervical cancer death rate in young women from the 1960s to the 1980s, but changes in several other factors could also be relevant.These include age at rust intercourse, number of sexual partners, prevalence of other sexually transmitted diseases, smoking, oral contraceptive use, and parity.Genital HPV infections are very common, sexually transmitted, and have peak prevalence between ages 18 and 30 years.The overall prevalence of genital HPV infection in the Albanian population was found to be 15.1% and it ranged from 25.2% in women aged <30 in many other countries.In addition, because HPV can be transmitted by any skin-to-skin contact, condoms are not as effective in preventing HPV infection as they are in preventing other STI (IARC 2005).
Cancer is more common among the women who do not have regular pap tests.SCC is seen 3.9 and 13 times more in a woman screened once in three years and 10 years, respectively, compared with ones screened annually (Kuo et al., 2003).In developed countries such as USA, 85% of women had at least one pap test through their lifetime, but this rate is only 5% in the developing countries (Kule, 2002).The screening coverage among women of reproductive age in Albania is extremely low, to 44 years old reported having ever been screened with a Pap smear, with additional differences observed among women in urban (4.9%) and rural areas (1.8%) (Morris et al., 2002).Altogether, 2.7% of women 15 to 44 years old reported having had a Pap smear performed regularly every 3 years (4.3% of women in urban areas compared to 1.5% of women in rural areas (Polona et al., 2013).Cost of health care, consults by the doctors, lack of perceived need (i.e., no symptoms), were the dominant concerns among these women.These issues kept women far away from routinely cervical screening.All these factors may be the reason of diagnosed SCC in advanced stage in Albania.Syndromes management remains the core and care for people with sexually transmitted infections in resource-poor settings where laboratory testing is not stis_strategy.pdf(accessed Sept 19, 2006).examinations were unsatisfactory.The main causes for CC inadequacy were sample obscured by red blood cells and can be caused by a number of factors, including poor of lubricants, or interpretive errors (Coskun et al., 2008).Although this unsatisfactory category constitutes 1% to 2% of all pap tests, patients with unsats are more likely to have histories of abnormalities and are at increased therefore it is important to monitor them closely (Coskun the proportion of unsatisfactory specimens from 1.1% unsatisfactory results (Colgan et al., 2004).
This paper highlights the abnormalities seen in CC in the Albanian population.Abnormal CC prevalence rate in Albania is lower than that in India and Europe differences, lack of screening population-based studies or a lower HPV prevalence.Further studies with larger numbers are required to fully assess the above mentioned factors, especially the role of HPV, to determine the real prevalence of the cervical epithelial abnormalities in Albania, to generate more reliable policies as to plan for future screening.In addition, our study population is comprised of women referred to Colposcopy due to an differences that would be seen in general population, our reported in the same and other populations.

Table 2
Pap smear and is 100% treatable.It can take years for these changes to turn into cervical cancer.Most women who are diagnosed with cervical cancer today have not had regular Pap smears or they have not followed up on abnormal Pap smear results.The precancerous lesions can evolution in cervical cancer, with the persistent cofactors like as smoking, partners, oral contraception, and the missing of cervical cancer screening, and if precancerous lesions are not treated, they can progress to cancer often in age more than 46 or less DiscussionAs cervical smears are not routinely performed in of preclinical disease.According the IARC data, the incidence for Albania is as low as 3.2/100,000 and ASR 7.1/100,000(Bray et al., 2013).

Table 2 . Cytology Diagnosis Correlation with Age- Group
*Total without unsatisfactory cases