Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Opportunistic Screening for Cervical Cancer in a Tertiary Hospital in Karnataka, India

  • Published : 2013.09.30
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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.

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References

  1. Adab P, McGhee SM, Yanova J, Wong CM, Hedley AJ (2004). Effectiveness and efficiency of opportunistic cervical cancer screening: comparison with organized screening. Med Care, 42, 600-9. https://doi.org/10.1097/01.mlr.0000128007.04494.29
  2. Autier P, Coibion M, Huet F, Grivegnee AR (1996). Transformation zone location and intraepithelial neoplasia of the cervix. Bri J Cancer, 74, 488-90. https://doi.org/10.1038/bjc.1996.388
  3. Basu P, Chowdhury D (2009). Cervical cancer screening and HPV vaccination: a comprehensive approach to cervical cancer control. Indian J Med Res, 130, 241-6.
  4. Bhatia R, Goel S, Pal S, Sareen AR 2001. Down staging of carcinoma cervix by Pap smear in high risk women. Obs. and Gynae, 4, 29-36.
  5. Boyd JT, Dol R (1964). A study of the aetiology of carcinoma of the cervix uteri. Br J Cancer, 18, 419-34. https://doi.org/10.1038/bjc.1964.49
  6. Chang JH, Rutkowski MA, Philips MA, Wilbur DC, Mesonero CE (1996). The potential biological and clinical significance of reactive/reparative cellular changes in cervical smears: a five year follow up study. Acta Cytol, 40, 1038.
  7. Giftson JS, Umadevi P, Kannika PS (2011). The present scenario of cervical cancer control and HPV epidemiology in India: an outline. Asian Pac J Cancer Prev, 12, 1107-15.
  8. Graaf YV, Vooijs GP, Gaillard HLJ, Go DMDS (1987). Screening errors in cervical cytologic screening. Acta Cytol, 31, 434-8.
  9. Gupta S, Rao YN, Agarwal SP (2002). Emerging strategies for cancer control in women of India: www.medindia.net/ education/ministry of Health/pg192-203.pdf.
  10. Kashyap V, Murthy NS, Bhatnagar P, Sharma S, Das DK (1995). Inter observer Agreement in the Diagnosis of Cervical Smears. Indian J Pathol Microbiol, 38, 375-82.
  11. Klinkhaemer PJJM, Vooijs GP, Haan AFJ (1988). Intra observer and Inter observer variability in the diagnosis of epithelial abnormalities in cervical smears. Acta Cytol, 32, 794-800.
  12. Lozowski MS, Mishriki Y, Talebian I, Solitare G (1982). The combined use of cytology and colposcopy in enhancing diagnostic accuracy of preclinical lesions of the uterine cervix. Acta Cytol, 26, 285-91.
  13. Malik SN, Wilkinson EJ, Drew PA, Hardt NS (2001). Benign cellular changes in Pap smears: causes and significance. Acta Cytol, 45, 5-8. https://doi.org/10.1159/000327180
  14. Miles A, Cockburn J, Smith RA, Wardle J (2004). A perspective from countries using organized screening programs. Cancer, 101, 1201-13. https://doi.org/10.1002/cncr.20505
  15. Mostafa MG, Srivannaboon S, Rachanawutanon M (2000). Accuracy of cytological findings in Abnormal cervical smears by cytohistologic comparison. Indian J Pathol Microbiol, 43, 23-9.
  16. Murthy NS, Sehgal A, Satyanarayana L, et al (1990). Risk factors related to biological behaviour of precanerous lesions of the uterine cervix. Int J Cancer, 61, 732-5. https://doi.org/10.1038/bjc.1990.164
  17. Roderick B, Dalmas M, Vincenta AC (2006). Effectiveness of opportunistic screening for cancer of the cervix uteri. Malta Med J, 18, 15-20.
  18. Robyr R, Nazeer S, Vassilakos P, et al (2002). Feasibility of cytology-based cervical cancer screening in rural Cameroon. Acta Cytol, 46, 1110-5. https://doi.org/10.1159/000327116
  19. Sankaranarayanan R, Chatterji R, Shastri SS, et al (2004). Accuracy of human papillomavirus testing in primary screening of cervical neoplasia: results from multicenter study in India. Int J Cancer, 112, 341-7. https://doi.org/10.1002/ijc.20396
  20. Sankaranarayanan R, Nene BM, Dinshaw KA, et al (2005). A cluster randomized controlled trial of visual, cytology and human papillomavirus screening for cancer of the cervix in rural India. Int J Cancer, 116, 617-623. https://doi.org/10.1002/ijc.21050
  21. Sankaranarayanan R, Nene BM, Shastri SS, et al (2009). HPV screening for cervical cancer in rural India. N Engl J Med, 360, 1385-94. https://doi.org/10.1056/NEJMoa0808516
  22. Shastri SS, Dinshaw K, Amin G, et al (2005). Concurrent evaluation of visual, cytological and HPV testing as screening methods for the early detection of cervical neoplasia in Mumbai, India. Bull World Health Organ, 3, 186-94.
  23. Sunanda BK, Rohlagai P, Tigai KG, Nigam SS (1968). A clinicopathological study of the benign lesions of the cervix. J Obst Gynec India, 18, 702-8.

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