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Background: Cervical Cancer is the second most common cancer among women in the world leading to 90% deaths in low and middle income countries. About 96,922 new Cervical Cancer cases are diagnosed annually in India. Objective: To study the knowledge, attitude and practice on Cervical Cancer and screening among women in India. Materials and Methods: Health sciences electronic databases PubMed and Google Scholar were searched for studies published between 2012 to March 2020. Keywords used for the search were (“Cervical Cancer screening”), (“knowledge”),(“attitude”), (“practice”) AND (“India”). 19 articles were included in the review based on the eligibility criteria. Statistical software SPSS-V.23 was used for the statistical application. Results: 7688 women were included in the study. Age of study participants ranged from 12-65 years. Overall knowledge on Cervical Cancer among women was 40.22%. Knowledge of risk factors and signs and symptoms was fairly adequate among the women. 32.68% of women knew that early age of marriage was a risk factor for Cervical Cancer followed by 23.01% women who mentioned that early age of initiation of sexual activity was a common risk factor for Cervical Cancer. Inter menstrual bleeding and foul smelling discharge was the most common sign and symptom reported in 30.75% and 28.86% women respectively. Knowledge, attitude and practice regarding Cervical Cancer screening was seen in 20.31%, 43.64% and 13.22% of women respectively. Conclusion: Effective information, education and communication strategies are required to improve the level of awareness of women on Cervical Cancer.

This treatment has excellent survival rates with acceptable morbidity, and recurrence is mostly distant.

New concept of downstaging locally advanced cancer of the cervix (LACC) with neoadjuvant chemotherapy (NACT), to make it resectable, is of great interest and needs to be explored. This is a retrospective study of 56 LACC patients. Efficacy of NACT was measured in terms of optimal pathological response (OR). Percentage of patients who needed adjuvant radiotherapy and disease-free interval at 2 years was evaluated. Clinically, 49 patients (87.5%) responded well to NACT with TIP regimen (paclitaxel, ifosfamide, and cisplatin) and underwent radical surgery. Adjuvant radiation was given for adverse factors in histopathology. Recurrences were noted; 46.4% of patients were in stage 2b, followed by 25% in stage IIIb; 92.8% of patients had squamous cell carcinoma. Optimal pathological response was seen in 15 patients (30.6%) with complete response in 8 patients (16.3%). Four patients (8.2%) had deposits in the parametrium, and 11 (22.4%) had positive nodes. On gross examination, 48.9% of patients had complete disappearance of cervical growth, and there was no microscopic evidence of cervical malignancy in 16.3%. In 20.4% of patients, cervical cancer was reduced to cervical intraepithelial neoplasia or microinvasion. Thirty-four patients (69.4%) needed full adjuvant radiotherapy. Overall, 14 patients (25.92%) had recurrence, with 11 (22.44%) being in NACT and radical surgery group. At 2 years, disease-free interval for 49 patients who underwent radical surgery was 69%. This study suggests that LACC patients who respond to NACT are surgically resectable with pathological cure in some cases, who are then spared from adjuvant radiation, which is given when recurrence occurs. However, with advancing stage, the percentage of OR decreases, and the need of adjuvant radiation increases.

Liesegang rings are rarely encountered in routine histopathology practice and are generally described in benign conditions. 1 However, our description in an ovarian neoplasm expands their spectrum in malignancies. [2][3][4] Recently, round to ovoid acellular eosinophilic rings were noted in histological sections from an endometrioid ovarian neoplasm ( Figure 1A-C) of a 36-year-old woman. Interestingly, these were confined to the central necrotic regions, within large endometrioid glands, exhibiting squamous metaplasia. The rings having characteristic concentric laminations around a central amorphous nidus were identified as Liesegang rings. They were nonbirefringent on polarizing microscopy and negative for epithelial membrane antigen (EMA). Their structural details were accentuated with periodic acid-Schiff stain.The smooth walled ovarian mass measured 10 × 7 cm. The cut surface was solid-cystic and revealed blood clots. While sections from the thin cyst wall had tubal type lining, the solid region displayed lobules of proliferating endometrioid glands. Examination of multiple sections revealed only occasional foci of confluent expansile tumor growth measuring >5 mm in greatest dimension. Herein, despite relatively bland nuclear features of lining epithelium and ≤2 mitosis/high-power field, there was architectural 697821I JSXXX10.1177/1066896917697821International Journal of Surgical PathologyJain et al research-article2017 Figure 1. (A) Microscopy revealed an occasional large () expansile lobule measuring >5 mm in greatest dimension, among smaller (→) lobules (hematoxylin and eosin, 20×). (B) Higher magnification of this large lobule revealed confluent endometrioid glands, lined by mildly pleomorphic cells with only occasional mitotic figures (). There were intervening sheets of squamous metaplastic cells and Liesegang rings (→) were seen confined to dilated glands (hematoxylin and eosin, 200×). (C) These rings (→)were seen in regions of necrosis, rimmed by squamous epithelium (hematoxylin and eosin, 400×). (C inset) The characteristic concentric laminations of Liesegang rings (→) were accentuated on PAS histochemistry (periodic acid-Schiff, 400×), but (D) they stained negative for EMA (immunostain, 400×).