Screening for Carcinoma of the Uterine Cervix in a V.D. Clinic

Abstract

Early diagnosis of carcinoma of the cervix by cervical smear has been the subject of many papers since the method was first described by Papanicolaou and Traut (1941) At a routine local genital examination, a scraping of cervical mucosa was taken with a wooden "mutton bone" spatula (Ayre, 1947) and spread evenly on to a slide marked with the patient's number. The slides were immediately stored in jars containing Schauddin's medium as a fixative and were taken to the laboratory once daily, where they were stained with haematoxylin and eosin and examined by the pathologist.In an initial series, the slides showed many abnormal cells due to inflammation, and a heavy overlay with pus cells and bacteria. It was therefore decided to delay screening until the patient had been given initial treatment (i.e. until the second or third visit). ResultsAmong the 235 cervical scrapes done, four were reported to be highly suggestive of carcinoma, and two contained suspicious cells. These six cases are reviewed below.Case Reports Case 1, an English woman aged 39, with a previous history of gonorrhoea, attended with a vaginal discharge. Non-gonococcal genital infection was diagnosed and treated. The cervix then appeared normal, but the cervical scrape showed atypical cells. She was referred to the gynaecological department, where biopsy revealed carcinoma in situ. She was-admitted for total hysterectomy. Case 2, an English woman aged 40, attended with trichomonal vaginitis. The cervical scrape showed atypical cells despite a clinically normal cervix, and carcinoma in situ was confirmed by biopsy. She was admitted for total hysterectomy.Case 3, a Barbadian woman aged 32, under treatment for gonorrhoea, was noted to have some patches of leukoplakia surrounding the external cervical os. The cervical scrape showed atypical cells. Biopsy confirmed this, and at total hysterectomy she was found to have Stage One carcinoma of the cervix, but without metastatic spread.Case 4, an English woman aged 38, presented because of post-coital bleeding. No signs of venereal disease were found, but she had a large erosion of the cervix, which was thought to be traumatic as she admitted to intravaginal manipulation with the handle of a breadknife 230 * Short paper read to the M.S

Pilot study of cervical cytology screening in a sexually transmitted diseases clinic.

“…24 Unfortunately few reports of cytology screening in STD clinics have been published, and we are only aware of six previous reports, five of which were published in the 1950s and 1960s. [25][26][27][28][29] The two most recent reports came from Birmingham, England, in 333 196725 and Seattle, United States, in 198030 and gave incidences of dysplasia and carcinoma in situ of 69 9% and 11 4%o respectively. These figures were both well over five times the incidence of abnormal cytology reported by their countries' national screening programmes.…”

Cytological Screening for Cancer in a Venereal Disease Program

“…Screening of special population groups for cancer of the cervix and uterus is probably more common than a review of the literature would indicate. Farrer and Tatham (5), reporting on a limited number screened in a venereal dis¬ ease clinic in St. Thomas Hospital, London, concluded that such screening ought to be en¬ couraged and adopted as routine procedure. Ferguson (6) pointed out in 1961 the signifi¬ cant yield of cancer in screening girls less than 19 years of age.…”

Sexually transmitted infections (STIs) in gynae-outpatients: Experience from a tertiary health centre

“…early onset of coitus and multiple sex partners. So, carcinoma cervix can be considered as one of 3 rd generation STDs [7]. Majority of women were ignorant regarding causes treatment and prevention of STIs [8].…”