Background: Cervical screening detects precancerous cells that may lead to cancer. Therefore, this study aimed to assess the correlation between cervical neoplastic changes and the features of vaginal discharge in Sudanese women who have undergone Pap screening.

Methodology: This prospective study was conducted in El-Obeid, North Kordofan State, during the period from May 2024 to May 2025. All participants (82 women) had presented to HighCare clinic in El-Obeid complaining of vaginal discharge.

Results: Most patients presented with whitish discharge (70.7%), followed by yellowish discharge (17%). Out of 58 patients with whitish discharge, 34.5% were identified with cytological atypia. Of the 20 patients with atypia, 65% had mild cytological atypia, 315% had moderate atypia, and 20% had severe cytological atypia. The association between whitish discharge and cytological atypia, the odd ratio (OR), and the 95% confidence interval (95%CI); OR (95%CI) = 1.3103 (0.5532 to 3.1037), p-value = 0.5390. Regarding odor, most patients presented with odorless discharge, 53.7% of whom were found to have cytological atypia (50% mild, 40% moderate, and 10% severe). About 46.3% of patients presented with offensive odor discharge, of whom 39.5% were detected with cytological atypia (66.7% mild, 7% moderate, and 27% severe). The association between offensive odor discharge and cytological atypia, OR (95% CI) = 1.7368 (0.6989 to 4.3162), p-value = 0.2346.

Conclusion: HPV is prevalent among Sudanese ladies at reproductive age, which is associated with increased epithelial dysplastic changes. Whitish offensive vaginal discharge might be associated with underlying cytological atypia.