Pattern of cervical lesions, with emphasis on precancer and cancer in a tertiary care hospital of Southern India

Abstract

Gender disparity in access to health care is well recognized in developing countries such as India. 1 Among non-communicable diseases, cancer of cervix occupies a prime position among malignancies in women. Worldwide , cancer of cervix is responsible for one of leading cause of death, with developing countries accounting for nearly 80% of 500000 new cases per year. 2 In developing countries, it is the most common malignancy in women. 3 The burden is worrisome because carcinoma cervix has known risk factors, has a long pre-clinical period when it can be effectively detected and treated. 4 However, preventive measures are rarely practiced in India, and women often present to hospitals only when they are symptomatic. Visakhapatnam is the largest city in Andhra Pradesh. It has a population of 1730320 according to the 2011 census. An earlier camp-based screening for cancer of ABSTRACT 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 acetowhite 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.

Recent trends in histopathological spectrum of malignancies among females in western Maharashtra

“…Gumpeny N. et al in Visakhapatnam, Andhra Pradesh, India, observed maximum number of cases (29%) between 41 and 50 years of age. 15 Similar finding was also reported by Lakshmi V and co-workers, in Tamil Nadu, India and found 39% patients to be between 41 and 50 years of age. 16 Squamous cell carcinoma was the most prevalent histopathological type followed by adenocarcinoma and neuroendocrine carcinomas.…”

A Study of Clinico-pathological Parameter of Carcinoma Cevix and Their Correlation with Treatment Outcome

“…There have been few studies on the association of HPV 16 and 18 from India in relation to cervical lesions. 4 The accumulated evidence suggests that cervical cancer is preventable and is highly suitable for primary prevention. 5 The usual 10-20 years of natural history of progression from mild dysplasia to carcinoma cervix makes this cancer as relatively early preventable disease and provides the rationale for screening.…”