Pattern of cervical lesions, with emphasis on precancer and cancer in a tertiary care hospital of Southern India
Keywords:
Leucorrhea, Hygiene, Socioeconomic statusAbstract
Background: Carcinoma cervix is the most common form of cancer in India. Screening is cost-effective but compliance is an issue. Most women present to hospitals at first visit. We studied the pattern of women with carcinoma cervix who presented to the gynecology outpatient department of a large hospital in southern India.
Methods: Women attending the gynecology outpatient department of King George hospital were evaluated for the presence of cervical lesions. A complete history was obtained. Biopsies from the cervix were obtained from the aceto-white areas, fixed in 10% buffered neutral formalin.
Results: 860 cervical biopsy specimens were received. By routine hematoxylin eosin stains, 180 had precancerous lesions and cancerous lesions with more than two risk factors; in the study period, a total of 253 cervical neoplasms were recorded: 103 were in the pre-cancerous stage (CINU1: 74; 71.84%, CIN II 20/103; 19.41%, CIN III 9/103; 8.73%). Of the 150 cancerous lesions, maximum were SCC non-keratinising (130; 92%). A subset (viz 45/180; 25%) were tested for HPV DNA using Polymerase Cycle Reaction (PCR). The commonest presenting symptom was leucorrhea (40%). Most women reported age of first intercourse below 30 years. On visual examination of cervix, most (25; 55.55%) had exophytic growth and erosion (14; 31.11%). More than 80% (n: 24) presented in stage II and III cancer (n:27).
Conclusion: In this hospital based study from a large institution from Southern India, out of 860 cervical biopsy specimens studied, 180 (32.14%) had precancerous lesions and cancerous lesions with more than two risk factors.
References
Veena S, Madhu K, Sridhar GR. Gender differences in coping with type 2 diabetes mellitus. Int J Diab Dev Countries. 2001;21:97-102.
Shanta V, Krishnamurthi S, Gajalakshmi CK, Swaminathan R, Ravichandran K. Epidemiology of cancer of the cervix global and national perspective. J Indian Med Assoc. 2000;98:49-52.
Sharma P, Rahi M, Lal P. A Community-based cervical cancer screening program among women of Delhi using camp approach. Indian J Community Med. 2010;35:86-8.
Christe DM, Mohanambal M, Ramamurthy V, Snehaa NB. A study of cervical cancer screening for prevention of carcinoma cervix. J Indian Med Assoc. 2008;106:779-80.
Bhagyalakshmi A, Devi Madhavi B, Vasundhara M, Sri KS, Vani I, Sreelekha A. Patterns of epithelial cell abnormalities in Pap smears and its clinicopathological and demographic association: a descriptive study from Visakhapatnam city, Andhra Pradesh, India. Int J Res Med Sci. 2014;2:300-5.
Misra JS, Singh U. Results of long term hospital based cytological screening in asymptomatic women. Diagn Cytopathol. 2006 Mar;34(3)184-7.
Dutta PK, Upadhyay A, Dutta M, Urmil AC, Thergaonkar MP, Ganguly SS. A case control study of cancer cervix patients attending Command hospital, Pune. Indian J Cancer. 1990;27:101-8.
Yasmeen J, Qurieshi MA, Manzoor NA, Asiya W, Ahmad SZ. Community-based screening of cervical cancer in a low prevalence area of India a cross sectional study. Asian Pac J Cancer Prev. 2010;11:231-4.
Kay P, Soeters R, Nevin J, Denny L, Dehaeck CM, Williamson AL. High prevalence of HPV 16 in South African women with cancer of the cervix and cervical intraepithelial neoplasia. J Med Virol. 2003;71:265-73.
You K, Liang X, Qin F, Guo Y, Gent L. High-risk human papillomavirus DNA testing and high-grade cervical intraepithelial lesions. Aust NZJ Obstet Gynecol. 2007;47:141-4.
Qiu AD, Wu EQ, Yu XH, Jiang CL, Jin YH, Wu YG, et al. HPV prevalence, E6 sequence variation and physical state of HPV16 isolates from patients with cervical cancer in Sichuan, China. Gynecol Oncol. 2007;104:77-85.
