Concordance between PAP smears and P53 expression in women with cervical abnormalities in Osogbo, Southwest, Nigeria

Cervical cancer screening, involving Papanicolaou (PAP) smear and assessment of p53 expression, is crucial for early detection and prevention of cervical cancer. The aim is to evaluate the concordance between Papanicolaou (PAP) smears and P53 expression in detecting cervical abnormalities in Osogbo women southwest, Nigeria. This cross-sectional study involved 221 women aged 18–65 attending Uniosun teaching hospital for cervical screening between January 2023 and December 2023. Cervical cytology was performed using PAP smears, and P53 expression was assessed through immunohistochemistry of the smear samples. The agreement between cytology, PAP smear results, and P53 expression were analyzed. Of the 221 women, 86 (38.9%) had abnormal Pap smear results, categorized as ASC-US, LSIL, or HSIL. P53 overexpression was observed in 86 (38.9%) cases. A statistically significant association was found between age group and Pap smear results, with a higher proportion of abnormal results among the 30–39 age groups. Additionally, a significant association was observed between miscarriage history and Pap smear results, with a higher proportion of abnormal results among those with more than two miscarriages. The relationship between PAP smear results and p53 expression revealed a statistically significant association (p=0.047), with a higher proportion of normal PAP smear results having negative p53 expression (99.3%) compared to abnormal PAP smear results (100% negative P53 expression). The concordance rate between Pap smear findings and P53 expression, indicating that there is no substantial agreement. The highest concordance was observed in normal cases (95.6%). This study suggests that p53 expression can be used as a complementary negative marker to Pap smear in cervical cancer screening although there was no concordance substantial between PAP smears and P53 expression in detecting cervical abnormalities. This could help in enhancing the accuracy of cervical cancer screening or for monitoring of the disease but not for diagnosis.