Prevalence of Cervical Intraepithelial Neoplasia (CIN) at Khulna Division of Bangladesh

Abstract

Back ground: Cervical cancer is the most common genital tract cancer and the important cause of cancer death among Bangladeshi women. Information about actual number of women living with preinvasive phase of cervical cancer and their diagnosis and treatment is limited. For strengthening the programme and policy for cervical cancer prevention , the baseline prevalence of cervical intraepithelial neoplasia ( CIN) need to be assessed.
 Methods: This population based study aimed to determine the prevalence of CIN among women of Khulna division of Bangladesh. Data has been collected from four upazila of four districts of Khulna division. VIA and colposcopy and histopathology was used for detection of cervical pre-cancers and early cancers among 1232 women of the mentioned population.
 Results: Crude prevalence of CIN was 5.84 %,CIN-II 1.1% and CIN- III .73% in colposcopically directed biopsy. Ninety two participants with CIN received treatment at the Colposcopy Clinic of Obstetrics and Gynaecology department of Khulna Medical College Hospital (KMCH).
 Conclusion: This population based prevalence study of CIN and socio demography would have conducive effect on future cervical cancer prevention programme.
 Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 21-28

Distribution of High-Risk Human Papillomavirus Genotypes among Women with Colposcopic Diagnosis of Cervical Intraepithelial Neoplasia in Bangladesh

“…This underestimation of HPV prevalence in this study is most likely due to the study methodologies. The prevalent genotypes of HPV among CIN cases of current study were HPV 16,18,31,33,35,52, 56 and 58 either as single or multiple infections. A prospective study from Varnasi and adjoining areas of India reported that HR HPV 16,18,31,33,35,45,58,86 were observed among CIN cases and cervical cancer cases [39].…”

“…The prevalent genotypes of HPV among CIN cases of current study were HPV 16,18,31,33,35,52, 56 and 58 either as single or multiple infections. A prospective study from Varnasi and adjoining areas of India reported that HR HPV 16,18,31,33,35,45,58,86 were observed among CIN cases and cervical cancer cases [39]. In Pakistan, the prevalent genotypes in cervical cancer were HPV 16,18,45,56,73.…”

“…This result is in contrast with studies done at Faridpur Medical College Hospital and at Khulna Medical College Hospital, Bangladesh. They reported 30% cases of HSIL [33] [34]. Dhaka Medical College hospital is the largest referral hospital of Bangladesh and may receive a greater number of HSIL cases from both government and private hospitals.…”

“…Written informed consent was obtained from patients before taking biopsies. Colposcopically guided cervical punch biopsies were taken for CIN cases and sent to the Department of Microbiology, Dhaka Medical College for the detection of high-risk HPV genotypes 16,18,31,33,35,39,45,51,52,56,58,59, 68, 70, 82 by Polymerase Chain Reaction (PCR) [27]. Variables examined included HPV subtypes, histopathological analysis of directed biopsies, and the characteristics of participants including age, income, and education.…”

“…Among these more than 40 have been shown to infect the genital tract. Chronic infection of the uterine cervix by one or more oncogenic Human Papilloma virus strains (16,18,31,33,35,39,45,51,52,56,58,59,68,70,82) leads to precancerous lesions (CIN I, CIN II, CIN III) [12].…”