Managing cervical cancer in Nepal: Need of consensual guideline

Abstract

The purpose of this review is to bridge the pattern of intervention in optimal and sub-optimal facility level. Several guidelines for the screening and treatment of cervical cancer are reviewed. Routine screening is found grossly lacking and non existent outside major health institution. Only nominal data and intervention efforts found published. There are three prongs of intervention level namely prevention/screening, treatment and palliation together. Pap smear test is the standard screening tool wherever the cyto-diagnostic facility exists. Visual Inspection with Acetic acid and Lugol's Iodine will be the feasible alternative at low resource setting. Primary surgical treatment for early cervical cancer is the best option. Likewise chemo-radiation with or without surgery will be the alternative option. Need of at least an operational guideline in each institution is realized at this moment as a recommendation.

Analysis of Pap Smear Database in a Community Hospital

“…In this study the age was grouped as per WHO recommendation for screening. 2,3 The recommended screening age of 30-65 years consists of four-fifth (3811, 79.4%) of data and 85.6% (173 out of 202) of abnormal smears. Maximum number of cases (3313 cases or 69%) was of age group 30-50 years followed by the age group of 21-29 years with a total number of 903 or 18.8%.…”