Introduction: Changing trends in the epidemiology of cervical cancer are reported from developing countries, but the new factors are not well documented, especially socioeconomic (SE) status.
Aim:To study the prevalence and factors associated with cervical cancer in upper middle SE class women from a tertiary care hospital in Chennai, South India.
Materials and methods:This is a case-control study of cases with cervical cancer and twice the number of asymptomatic controls, among women who underwent papanicolaou (PAP) smear test during 2009 to 2015.Results: Of the 3,536 PAP smears examined, 48 (1.36%) had cervical cancer and 96 age-and year-matched controls were selected for the cases. The mean (± standard deviation, SD) age of cases was 51.3 (± 12.7) years and controls was 51.7 (± 12.7) years (p not significant, NS). Over 90% of both groups underwent surgical sterilization and had long married lives. The median parity of cases and controls was 2. Parity was 3 or more in 22 (44.9%), compared with 27 (28.1%) in controls (p < 0.05; relative risk, RR: 1.6 and 95% confidence interval, CI: 1.3-1.9). Among all the cases, 23 (48.0%) were asymptomatic. More than half, 28 (58.3%), of the cases and 50 (52.1%) of the controls had attained menopause (p = NS). About 7 (25%) of these cases reported postmenopausal bleeding (PNB).
Conclusion:Among the PAP smears tested, high prevalence (1.36%) of cervical cancer was noted. The associated factors were age >50 years, median parity of 2, history of PNB, and a long duration of sexual exposure. Nearly half the cases were asymptomatic, highlighting the need for routine screening of all postmenopausal women.