Prevalence of abnormal Papanicolaou smears in female sex workers in Hong Kong

Objective To investigate the prevalence of pre-cancerous uterine cervix lesions as detected in Papanicolaou (Pap) smears from female sex workers in Hong Kong. Design Retrospective analysis of laboratory records. Setting Private anatomical pathology laboratory, Hong Kong. Patients Female sex workers undergoing Pap smear examinations at two non-governmental organisations between 2006 and 2012. Main outcome measures Detection of pre-cancerous uterine cervical conditions and their management. Results A total of 2697 satisfactory Pap smears from female sex workers were performed during the study period from 2006 to 2012. In these subjects, the point prevalence of low-grade squamous intraepithelial lesion and atypical squamous cells of unknown significance was 10.12% (compared with 3.92% for the general population during the same period), whereas that of high-grade squamous intraepithelial lesions and atypical squamous cells of unknown significance with or without high-grade intraepithelial lesions was 2.22% (compared with 0.54% in the general population). For both categories of lesions, the higher prevalence among female sex workers than in the general population was statistically significant. Most patients who had abnormal Pap smears received proper referrals and follow-up management according to recommended guidelines. Conclusions Female sex workers in Hong Kong as a group had a significantly higher prevalence of abnormal Pap smears than the general population. Non-governmental organisations providing free-of-charge screening services to these women helped early detection and proper follow-up for those who had abnormal Pap smears, whilst also increasing their awareness of women's health issues.