Clinico-pathological profile of patients with suspected cervical carcinoma (original) (raw)
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The Journal of South Asian Federation of Menopause Societies, 2015
Background: Cervical cancer is the most common cause of cancer-related death among women in developing coun tries. An attempt was made to know the impact of cancer screening programs in place since 1975 in India, and to do cervical cancer screening in symptomatic women atten ding gynecology outpatient department (OPD) by a combination of cytology and colposcopy. Materials and methods: A total of 200 women in the age group of 21 to 65 years who attended gynecology OPD who consented to participate were screened by Pap smear testing and colposcopy. Women who were pregnant, and known or treated case of cancer cervix were excluded from the study. Pap smears were made with conventional method and colposcopy was done. Women were treated simultaneously with cryocautery. Results: None of the women had Pap smear testing in their life earlier suggesting need for an organized screening program. Mean age was 38.6 years. Sensitivity and specificity of Pap smear for diagnosis of low-grade squamous intraepithelial lesion (LSIL) was 76.9 and 96.2% while that for the diagnosis of high-grade squamous intraepithelial lesion (HSIL) was 66.6 and 97.6% respectively. Sensitivity and specificity of colposcopy in the diagnosis of LSIL in the present study was 92.3 and 100% while that for diagnosis of HSIL was 50 and 100% with 100% positive predictive value (PPV) and 92.1 to 96.5% negative predictive value (NPV). When a combination of Pap smear and colposcopy was used, the overall sensitivity and specificity for diagnosis of LSIL + HSIL was 94.7 and 90.9% respectively, and PPV and NPV was 90 and 95.2%. Conclusions: The advantage of the combination of simultaneous testing with Pap smear and colposcopy lies in its strong negative predictive value, which can decrease the frequency and closeness of follow-up required in poor resource settings. The present study supports the claim to perform combined screening tests as a routine to detect maximum number of cases with accuracy.
2016
Objective: Stage at diagnosis and factors associated with late diagnosis of cervical cancer have been analyzed in this study. Materials and Methods: It is a hospital based cross sectional study carried out enrolling 246 cervical cancer patients attending outpatient department of tertiary cancer hospital of Odisha, India. The patients were interviewed and histopathological observations were recorded from investigation reports. Factors for late stage presentation were analyzed by using multivariate logistic regression analysis. Results: 56 (21.96%) cases were presented for diagnosis at early stage (I&IIA) and 194(78.04%) at late stage (IIB and above). Late stage diagnosis was associated with higher age i.e., ≥40years (OR=2.54 95% CI=1.11-5.83), poor treatment seeking behavior (OR=2.23, 95% CI=1.001-5.23), lack of awareness (OR=1.91, 95% CI=.43-8.41), lower education level (OR=1.59, 95% CI=.73-2.45) and initial symptoms with painless bleeding/discharge (OR=7.38, 95% CI 3.22-16.89). Conclusion: In the absence of screening programme prevalence of late stage diagnosis of cervical cancer was significantly higher. This could be attributed to higher age at presentation, low education, low awareness about the disease and its symptoms and poor treatment seeking behavior. Specific health programme is suggested for women emphasizing cervical cancer screening and awareness regarding signs and symptoms of cervical cancer to enhance health seeking behavior among them.
Study of cytological pattern of pap smears and detection of cervical cancers in Gujarat, India
IP innovative publication pvt. ltd, 2019
duction: Cervical cancer is one of the leading causes of morbidity and mortality. It can be preventable and diagnosed early with adequate and repetitive cytological screening by pap test. The conventional cervical cytological screening is the most common technique used throughout the world. Objective: To characterize the age and pattern of Pap smear abnormalities in a population of Gujarat, India. Materials and Methods: A retrospective study was conducted at tertiary care hospital of Gujarat India. All previously collected pap smear from 2011 -2014 was evaluated for cytological pattern and during this duration total 1100 pap smear was evaluated. Results: The mean age of patients with abnormal smears was 37.5 years. The mean parity was 4.34. There were 46 (4.18%) unsatisfactory smears and 1054(95.82%) adequate smears. Atypical squamous cell of undetermined significance(ASCUS), low grade squamous intraepithelial lesion (LSIL), and high grade squamous intraepithelial lesion (HSIL) were reported in 69 (6.54%), 111(10.53%), and 55 (5.21%) women respectively. Atypical glandular cell and squamous cell carcinoma were reported in 10 (0.94%) and 5 (0.47%) respectively Conclusion: This study emphasized the importance of Pap smears screening for early detection of premalignant and malignant lesions of cervix. Pap smear testing is a very useful, simple, economical and safe tool to detect preinvasive cervical epithelial lesions. Hence, on a routine basis, every woman above the age of 30 must be subjected to Pap smear and this must be continued even in post-menopausal period as most of patients with epithelial abnormalities in our study falls in this group.
International Journal of Research in Medical Sciences, 2016
Cervical cancer is the fourth most common cancer in women and the seventh overall, with an estimated 528,000 new cases every year. Cancer cervix is the most common cancer in women in several less developed countries, and now the second most common cancer in India. Almost 70% of the global burden of cervical cancer is in areas with lower levels of development, and more than one fifth of all new cases are diagnosed in ABSTRACT Background: Cervical cancer is the fourth most common cancer affecting women worldwide, the most common cancer in women in several less developed countries, and now the second most common cancer in India. Cervical cytology by papanicolaou (PAP) smear test is an effective tool for detecting abnormal cytology in early stages, thus allowing early detection and treatment. The PAP smear is extremely important for detecting premalignant and malignant conditions of cervix. The study was conducted to determine; (1) Cytomorphologic incidence of various lesions of uterine cervix; (2) Categorization of detected lesions according to Bethesda system; (3) Determination of epithelial abnormalities by cervical cytology. Methods: The settings and design of this study is a hospital based prospective study from a tertiary care centre in Central India. A total of 5813 conventional pap smear tests collected from January 2010 and December 2014 were analyzed. All patients attending outpatient department of obstetrics and gynecology for complaints of abnormal cervical discharge, dyspareunia, inter-menstrual bleeding, post-coital bleeding and lower abdominal pain were included. Various cervical pap screening camps were also done during this period. Smears were fixed and stained with hematoxylin & eosin (H&E) and papanicolaou stain were done. Results: The overall frequency of normal, inadequate, inflammatory, and abnormal smears was 11.86%, 5.73%, 74.98% and 13.2% respectively. Atypical squamous cell carcinoma of undermined significance (ASCUS) was seen in 3.61%, squamous intraepithelial lesion (SIL) was seen in 5.36%, low grade squamous intraepithelial lesion (LSIL) was seen in 2.59% while high grade squamous intraepithelial lesion (HSIL) was seen in 2.77%. Invasive carcinoma was seen in 3.69%. The premalignant epithelial abnormalities like ASCUS, LSIL and HSIL were found to be highest in the age group of 31-50 years in our study, which correlated well with other similar studies. Conclusions: Hence we should advocate regular cervical cytology (PAP) smear study, which can help to treat cervix lesions early before the progress into cervical cancer. Early detection is the only key to saving a woman's life as the later the abnormalities are discovered; mortality, morbidity and treatment cost all increase.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
According to WHO (world health organisation), Cervical cancer is the second most common cancer in females and is a major cause of morbidity and mortality. 1 Global report published by WHO in 2014, shows that around 2,66,000 women died from cancer of cervix in the year 2012. 2 Therefore this cancer is taking a toll on the health of women worldwide. Among the South-Asian countries, India has the highest age standardization incidence of cervical cancer at 22, compared to 19.2 in Bangladesh, 13 in Sri lanka and 2.8 in Iran. So it is very important to understand the epidemiological pattern and diagnose cervical cancers at an early stage. 3 Pap smear is a simple, safe, non-invasive and cost effective method for the detection of pre-cancerous, cancerous and benign lesions of cervix. 4 It is a sensitive test for early screening of cervical lesions and most
International Journal of Health Sciences and Research, 2012
Objective: Worldwide, cervical cancer is the 2nd most common cancer in women. 80% of all the cases of cervical cancer occur in the developing countries. Cervicovaginal cytology (Pap) is an effective means of screening for cervical lesions. The objective of this study is to determine the prevalence of abnormal cervical lesions with respect to clinicopathological and social aspect of cancer screening in rural India. Material and Methods: This was hospital based study of 930 Pap smears. The time period was from June 2004 to June 2009. The patients presented with leucorrhoea, low back pain, irregular vaginal bleeding, dyspareunia were included. Unsatisfactory smears and patients without clinical history and age were excluded from the study. The 2001 Bethesda system of interpretation of smears was used as a guideline. Result: In this study, leucorrhoea was the main common complaint (69.3%) followed by low backache (33.5%). Majority (36.5%) of the patients belongs to 3-4 decades with mean...
Opportunistic screening for cervical cancer in a tertiary hospital in Karnataka, India
Asian Pacific journal of cancer prevention : APJCP, 2013
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 neopla...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Cervical cancer is one of the most common forms of cancer. In India it is the second most common cancer after breast carcinoma. PAP smear is the best screening method to reveal spectrum of lesions in cervix ranging from inflammatory to the neoplastic process. Because of easy accessibility of cervix, cervical screening is helpful for ready diagnosis of 90 % to 96 % cytological abnormalities even in the pre-invasive stage. We wanted to evaluate the importance of PAP smear examination as a preliminary method accommodating histopathology and assess the spectrum of lesions. METHODS The study was done to identify the target age groups for the early detection of cancerous cervix by PAP smear examination. The study was done on patients who attended government general hospital (GGH), Ongole, from January 2018 to December 2019. Lesions were categorized based on 2014 Bethesda system as negative intraepithelial lesion for malignancy (NILM) / Inflammatory, benign, premalignant, and ma...
Cervical cytology plays an important role in diagnosis of cervical dysplasia and invasive cervical cancer within hours to days in subject to the availability of the Pap test facility in a health centre. The present study was carried out with the aim to detect the abnormality in the uterine cervix among the women of age group 20-65 years who attended gynecology OPD of Gauhati Medical college during September, 2011 to August, 2012; also to find out the association of dysplasia detected by cytology with age factor and parity status of the women. The procedure included scrapping from transformation zone of uterine cervix by exposing the cervix with help of Cusco's speculum; then smeared in a clean grease free glass slide, alcohol fixed and stained with papanicoloau stain. Smears were reported according to the Bethesda system 2001 which showed 88.05% smears were negative for CIN and 11.95% were showing positive results with varying degree of CIN to invasive cancer. There exists a sig...