Opportunistic Screening for Cervical Cancer in a Tertiary Hospital in Karnataka, India

Abstract

The incidence and mortality of cervical cancer remains high in India even after sixty years of introduction of the Pap smear (cervical cytology) which is an effective means of identifying preinvasive lesions of carcinoma cervix. The morbidity and mortality due to cervical cancer has come down drastically in countries with well established screening programmes at national level. This study aims at screening women for cervical cancer opportunistically during their visit to hospital and to study various types of neoplastic and non-neoplastic lesions of the cervix by cervical smear study (Pap smear study). In the present study, a total of 350 cervical smears were studied. The age of patients ranged from 19 years to 80 years with mean age being 37.5 years. Out of 350 cases, the diagnosis of neoplasia was given in 43 cases and 258 cases were diagnosed as inflammatory smears. Forty-cases were normal and 9 cases were inadequate to evaluate. Forty-three patients who were found to have neoplastic lesions on cytology were referred for further investigations like colposcopy and biopsy to confirm the diagnosis and avail proper treatment. Limitation of the present study was small sample size as all female patients aged between 20 and 60 years visiting hospital were not included in the screening, other screening tests like VIA (visual inspection with acetic acid test) and HPV DNA (human papilloma virus) tests were not done. Until the time centrally organised screening programmes for cervical cancer are established in India, arrangements should be made for hospital based opportunistic screening for all women attending hospital. The cost effectiveness of different screening tests for cervical cancer should be evaluated.

Cervical Cytological Screening Results of 8,495 Cases in Turkey - Common Inflammation but Infrequent Epithelial Cell Abnormalities?

“…7 years in Kulkarni's study. (Kulkarni et al, 2013;Sogukpınar et al, 2013). The mean ages were comparable and the differences may be because of the social behaviours.…”

“…In our study there were 363 bacterial vaginosis cases, 183 candida cases and 53 actinomyces cases and no other microorganisms were found in significant numbers. In Kulkarni P R's study the most common microorganism was trichomonas (1.94%) followed by candida (0.39%) (Kulkarni et al, 2013). Robry had reported a high incidence of Gardnerella Vaginalis (Robry et al, 2002).…”

“…As we know the main focus of cervical screening is the detection of cervical abnormalities, we saw that we have to question why our epithelial cell abnormalities were lesser than the other studies from many countries. Veena K reported the ratio of squamous epithelial abnormalities as 3% and Kulkarni PR reported it as 12% (Veena, Suresh, 2011;Kulkarni et al, 2013). According to Almobarak A the ratio was 3.4% (Almobarak et al, 2013) In Turkey the prevalence of abnormal smear was reported as 1.8% (Turkish Cervical Cancer and Cervical Cytology Research Group, 2009) and it was 2.8% in a study by Atılgan (Atilgan et al, 2012).…”

Oral cancer awareness of the general public in coastal village areas of Tamilnadu, India: a population based cross sectional study

“…This is implemented through National Cancer Control Programme(NCCP) and National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular diseases and Stroke (NPCDCS). 16,17 It is surprising to note that most of the people (6.4%) believe that lung cancer is the easiest cancer to detect by the health professionals followed by breast and oral cancer. This may be due to the awareness towards lung cancer in media and cigarette packs, but the fact that oral cancer can be easily detected than lung cancer should be reached to the public through mass campaign.…”

Comparative Evaluation of Two-dimensional Radiography and Three Dimensional Computed Tomography Based Dose-volume Parameters for High-dose-rate Intracavitary Brachytherapy of Cervical Cancer: A Prospective Study

“…So, the findings should be interpreted with caution. As the incidence and presentation in advanced stage remains a challenge despite screening by cervical cytology, policy makers in India should organize hospital based screening for all women attending hospital for early diagnosis, therapeutic intervention (Kulkarni et al, 2013). Health education towards awareness, risk factors and disease symptoms in women is also important for early detection (Shruti et al, 2014).…”