A Study of Cervical Pap Smears in central India: a city based study
Abstract
Introduction: The most common cancer of women in our country is cervical cancer (24/100,000) followed by breast cancer (21/100,000). Some inflammatory lesions like Trichomonas and Human papiloma virus are forerunners of malignancy underlining the importance of diagnosing these conditions early.
Methods: The material for the present study comprised of examination of 500 cervical/vaginal smears taken from patients attending OPD. Papanicolaou staining was used for staining. Cases were reported according to The Bathesda System.
Result: In the present study low grade squamous intraepithelial lesion were found in 35 cases (7%). High grade squamous intraepithelial lesion was found in 25 cases (5%). Invasive carcinoma cervix was found in 7 cases (1.4%). Atypical epithelial cells of uncertain significance were found in 65 cases, of which 50 cases were reported as ASCUS and 15 cases were reported as AGCUS. In the present study significant number of patients with history of early age at marriage (34 cases) and first child before 18 years of age (37 cases) presented with squamous intraepithelial lesions (LSIL + HSIL). Carcinoma cervix was found to be correlated with early age of marriage and first child birth before 18 years of age.
Conclusion: Cervical cancer can be detected at a very early stage by simple technique of exfoliative cytology. Early stage detection is important because early stage is 100% curable, reducing the morbidity and mortality from invasive cancer cervix.
Downloads
References
2. VG Padubidri, Shirish N Daftary.Howkins and Bourne Shaw’s Text Book of Gynecology.14th Edition Elsevier Publication;2009.
3. National Cancer Institute. Surveillance Epidemiology and End-Results. Washington (DC): Department of Health and Human Services; 1998.
4. D.Maxwell,Parkin ,Freddie Bray,Jacques Ferlay, Paola Pisani Estimating the world cancer burden: Globocan 2000: International Journal of Cancer 94, ( 2): 153–156, 15 October 2001.
5. Martin N, Srisukho S, Kunpradist O, Suttajit M. Cancer survival in Chiang Mai, Thailand. IARC Sci Publ 1998;(145):109–21. [PubMed]
6. Boon ME, Schwinghammer H, van der Veen G. Analysis of lifestyle data and cytologic findings in a pilot cervical screening project in rural Vietnam. Acta Cytol1999;43:786–93. [PubMed]
7. Parkin DM. Cancer in developing countries. Cancer Surv 1994;19–20:519–61. [PubMed]
8. Munoz H, Bosch FX. HPV and cervical neoplasia: review of case-control and cohort studies. IARC Sci Publ 1992;(119):251–61. [PubMed]
9. Apgar BS, Zoschnick L, Wright TC (November 2003)."The 2001 Bethesda System terminology". Am Fam Physician 68 (10): 1992–8. PMID 14655809. [PubMed]
10. Solomon D. The Bethesda System for reporting cervical/vaginal cytologic diagnoses: developed and approved at the National Cancer Institute Workshop in Bethesda,
Maryland, December 12-13, 1988. Hum Pathol. 1990 Jul;21(7):704-8.
11. Samuel Broder. Rapid communication: The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses—Report of the 1991 Bethesda Workshop. JAMA. 1992. 267(14).: 1892.
12. Harry W. Haverkos :Multifactorial etiology of cervical cancer:a hypothesis,med gen med 2005;7(4):57 Published online 2005 November 30. [PubMed]
13. Baseman JG, Koutsky LA. The epidemiology of human papillomavirus infections. J Clin Virol. 2005 Mar; 32Suppl 1:S16-24. [PubMed]
14. Mukherjee BN, Sengupta S, Chaudhuri S, Biswas LN, Maiti P. A case-control study of reproductive risk factors associated with cervical cancer. Int J Cancer 1994;59: 476–82. [PubMed]
15. Biswas LN, Manna B, Maiti PK, Sengupta S. Sexual risk factors for cervical cancer among rural Indian women: a case-control study. Int J Epidemiol. 1997 Jun;26(3):491-5. [PubMed]
16. De Sanjosé S, Bosch FX, Muñoz N, Shah K. Social differences in sexual behaviour and cervical cancer. IARC Sci Publ. 1997;(138):309-17. [PubMed]
17. Bjørge T, Kravdal. Reproductive variables and risk of uterine cervical cancer in Norwegian registry data. Cancer Causes Control. 1996 May;7(3):351-57. [PubMed]
18. Muñoz N, Franceschi S, Bosetti C, Moreno V, Herrero R, Smith JS, Shah KV, Meijer CJ, Bosch . Role of parity and human papillomavirus in cervical cancer: the IARC multicentric case-control study. Lancet. 2002 Mar 30;359(9312):1093-101. [PubMed]
19. Ponten J, Adami HO, Bergstorm R, Dillner J, Friberg LG, Gustafsson L, et al. Strategies for control of cervical cancer. Int J Cancer1995; 60: 1–26. [PubMed]
20. Parkin DM, Sankaranarayanan R. Prevention of cervical cancer in developing countries. Thai J Obst Gynaecol 1999; 11: 3s–20s. [PubMed]
21. Sankaranarayanan R. Integration of cost-effective early detection programs into the health services of developing countries.Cancer 2000;89(3): 475–81.
OAI - Open Archives Initiative
