Socio-Demographic, Reproductive and Clinical Profile of Women Diagnosed with Advanced Cervical Cancer in a Tertiary Care Institute of Delhi

Abstract

Introduction Cervical cancer is one of the leading cancers among Indian women with estimated 123,000 new cases and 67,477 deaths in 2012. Cervical cancer is a multietiological disease. Factors such as low socioeconomic status, tobacco use, sexual and reproductive factors, HIV and other sexually transmitted diseases and long-term oral contraceptive use have been suggested as determinants. Assessment of socio-demographic profile and reproductive history gives a better picture of the determinants of cervical carcinoma in low-resource settings. Methods This hospital-based cross-sectional study was undertaken at a tertiary healthcare institute at New Delhi, India. Sixty-seven newly diagnosed women with advanced cervical cancer (stage 2B-4B), who were undertaking radio-and/or chemotherapy, were included to assess their socio-demographic, reproductive and clinical profile. 123Results The mean age of women at the time of detection of cervical cancer was 52.28 ± 11.29 years (range 30-75 years). More than 60 % of patients were illiterate and belonged to middle socioeconomic status. Thirty-nine percentage of the study subjects had their first sexual experience before 15 years of age. Nearly 54 % women had 5 or more pregnancies. Nearly 73 % of women had all deliveries at home. Majority (69 %) of women had symptoms suggestive of reproductive tract infection. Among them, unusual discharge from vagina (73.13 %) followed by bleeding after menopause (55.10 %) and pain in abdomen (44.77 %) were the most common presenting complaints. Pallor was present in nearly two-third (63.93 %) study subjects. More than half (56.72 %) study subjects had moderate anemia, and 7.46 % had severe anemia before treatment. Mean hemoglobin level of the study subjects was 10.35 ± 1.72 gm% before treatment and 9.69 ± 1.29 gm% after treatment. This difference was statistically significant. Around 97 % of the study subjects had squamous cell carcinoma of the cervix. Majority (53.73 %) of the study subjects were in stage 3B of cervical cancer. Combination of radiotherapy and chemotherapy was the most common (77.67 %) modality of treatment.Conclusions and Recommendations Illiteracy, low socioeconomic status, early sexual debut, high fertility, home delivery, reproductive tract infections, use of insanitary clothes during menstruation and anemia were observed in majority of women with advanced cancer cervix. Presence of these factors indicates possible risk of cervical cancer and should be kept in mind when women seek health services. Early diagnosis through high risk or opportunistic screening and timely management of cervical cancer needs to be ensured for better outcomes.

Expression of p16INK4a and human papillomavirus 16 with associated risk factors in cervical premalignant and malignant lesions

“…[4,5] In addition, various risk factors including socioeconomic status and sexual and reproductive factors may also be associated with cervical cancer which may vary in different geographical regions. [6] The present study was therefore conducted to assess the immunoexpression of p16 INK4a in premalignant and malignant lesions of the cervix and to correlate it with HPV 16 expression. In addition, it was also intended to study the various risk factors which may be associated with cervical cancer in this North Himalayan Region of India.…”

Correlation between Visual Analogue Scale Score and Hospital Anxiety Depression Scale-Depression Score in Patients with Cervical Cancer in the Hospital Vina Cancer, Medan

“…In this study, the most at the first age sexual intercourse for ≤ 18 years is 52.9%, this study was by the results of a study by Wulandari that obtained 59.2% [12]. Likewise, with the study conducted by Dahiya in India, the results were obtained 70.15% for first age sexual intercourse ≤ 18 years [5]. This is because biologically from the cervix is immature during adolescence, making it more susceptible to HPV infection, and other sexually transmitted diseases [13].…”

“…For the marital status is most married was 76.5%, by a study conducted by Dahiya et al in India, that the most cervical cancer was obtained at the marital status of 73.13% 5. The most employment status is 58.8%., the study conducted by Endarti et al, found that the highest employed status was work is 71% [10].…”

“…The first sexual intercourse before the age of 18 is also a risk factor for the Human Papilloma virus for cervical cancer. Nearly 40% of the study subjects had sexual intercourse 1-2 years after menarche [5]. Sign in Cervical infections are common problems among women are associated with clinical complaints of vaginal discharge [6].…”

Clinical and Histopathological Comparison of Two Historical Series of 142 Wertheim-Meigs Operations Performed in a Reference Center in Brazil

“…Human Papilloma Virus (HPV) is the most important etiologic factor in majority of cases of cervical cancer, with HPV DNA identified in approximately 95% of malignant cervical lesions. Other risk factors such as low socio-economic status, tobacco smoking, sexual habits, HIV, other sexually transmitted diseases, long-term oral contraceptive use, certain micronutrient deficiencies and genetic susceptibility have been suggested as determinants [3]. Treatment depends on the clinical stage of the disease according to the classification of the International Federation of Gynecology and Obstetrics (FIGO) [4,5].…”