Cervical Cancer Screening with Cytology and Colposcopy in Rural Medical College Hospital of Himachal Pradesh, India

Author(s):  
Ashok Verma ◽  
Amrita Singhal ◽  
Suresh Verma
2019 ◽  
Vol 33 (1) ◽  
pp. 11-16
Author(s):  
Mst Moonmoon Begum ◽  
Ferdousi Sultana ◽  
Hasina Ferdousy

Background: Prevention of cervical cancer is the easiest with regular screening tests and follow up. CIN is a pre-malignant condition, detection of which is possible by VIA and colposcopy. Objective: To identify the performance of Cervical Cancer Screening Program in Rangpur Medical College Hospital through 11 Years. Methods and materials: Apparently healthy, married or sexually active women (>10 years) and women aged >30 years attending Gynae OPD were included in this study. After counseling and informed consent a speculum examination was performed for direct visualization of cervix to identify the squamo-columner junction. Freshly prepared 5% acetic acid was applied to the cervix for one minute. All the VIA positive women were further evaluated by colposcopy. Women with negative VIA were advised for 3 yearly VIA test. Suspected CIN cases were evaluated by colposcopy guided punch biopsy or LEEP biopsy and histopathology. Results: VIA screening was provided for 11,792 women from August 2005 to August 2016 and 932 (7.9%) were positive VIA. From November 2007 to August 2016, total women underwent colposcopy were 1548. Among them 632 (40.8%) were normal, out of abnormal cases 730 (80.3%) were CIN-1, 147 (16.1%) were CIN-2, 14 (1.5%) were CIN-3, 17 (1.8%) were invasive and 8 (0.5%) were unsatisfactory. From November 2007 to August 2016 punch biopsy was taken in 384 women and total 568 women were treated by LEEP. Conclusion: In a low resource setting like Bangladesh VIA and colposcopy can detect 80% pre-invasive cervical lesion and may be one of the most important tool to prevent cervical cancer and its mortality. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 11-16


2020 ◽  
Vol 4 (3) ◽  
pp. 189
Author(s):  
Abu Sadat Mohammad Nurunnabi ◽  
Tahmina Sultana

Background: National screening programme for cervical cancer has been running in Bangladesh since 2004 through visual inspection using acetic acid (VIA). However, Pap’s smear is also used for the same, where it is available.Objectives: To see the effectiveness of VIA and Pap’s Smear as cervical cancer screening methods.Methods: This prospective study was done on 600 women who attended the outpatient gynaecology clinic and cervical cancer screening programme underwent both VIA and Pap’s smear cytology. Histopathology was taken as gold standard to compare the performance of VIA and cytology (Pap’s smear). Hence, positive cases were further subjected to colposcopy directed biopsy. Then the sensitivity and specificity of VIA and Pap’s smear were compared. The study was done in Dhaka Medical College Hospital, Dhaka, between July and December 2012.Results: On VIA, 46 had aceto-white lesions and on Pap’s smear, 28 had atypical squamous cells of undetermined significance (ASCUS) or worse lesions out of 600 women screened. 22 were positive on both VIA and cytology; 24 were positive on VIA only; and 6 were positive on cytology only. Histological diagnosis of CIN/carcinoma cervix was found in 36 positive cases, who underwent biopsy (n=52). Among them, 20 were picked up from Pap’s smear positive cases, whereas, 34 were VIA positive cases. VIA was found more sensitive (94.44%) than Pap’s smear (55.55%), which was statistically significant (p<0.001). However, the specificity of VIA was slightly lower (97.87%) than that of cytology (98.58%). Positive predictive value (PPV) of VIA was 73.91% for VIA and 71.42% for Pap’s smear, while Negative Predictive Value (NPV) were 9.63% and 97.2% respectively.Conclusion: VIA has got much more sensitivity and slightly lower specificity than that of Pap’s smear in cervical cancer screening.International Journal of Human and Health Sciences Vol. 04 No. 03 July’20 Page : 189-193


Author(s):  
Susmita Chaudhuri ◽  
Rekha Dutt ◽  
Shweta Goswami ◽  
Joydeb Roychowdhury

Background: Cervical cancer is a leading cause of morbidity and mortality in women especially India. The mainstay of prevention rests on early detection of cases through screening. So, this study aims to determine the knowledge of cervical cancer screening, Human papilloma virus & its vaccination status. Methods: This was an observational study of cross-sectional design conducted among the adult reproductive aged women (18-45 years) visiting Gynaecology OPD at ESI-PGIMSR and ESIC Medical College and Hospital, Joka. A pre-designed and pre-tested interview schedule was prepared. Face to face interview was conducted in local language. Data was compiled & computed in SPSS software version 20. Results: Total respondents were 97. Majority of the respondents (62.9%) belong to the age group of 21-30 years. 8 in 10 participants follow Hinduism. Almost equal percentages of participants were from urban & rural areas (51.5% & 48.5% respectively). 6 in 10 participants had heard about cervical cancer. Majority of the respondents (55%) mentioned friends & family as a source of information. 48.3% of the respondents knew poor genital hygiene as a predisposing risk factor for cervical cancer. Very few knew about other factors like multiple sexual partner (20%), early marriage (33.3%), young age (20%), repeated childbirth (35%), OCP usage (26.7%) as risk factors for cervical cancer. Only one participant had undergone screening test for cervical cancer (1.7%). 46.7% of the respondents were aware about association of HPV infection with cervical cancer. But none of the participants had received vaccine against cervical cancer & they cited lack of awareness as a reason for not receiving the vaccine. Conclusions: A well-designed health education program focusing on effective multipronged IEC strategies utilizing pictorials, audio-visual and personal communication on cervical cancer could yield beneficial results. 


2020 ◽  
Vol 5 (2) ◽  
pp. 1055-1059
Author(s):  
Raj Deb Mahato ◽  
Amit Deo ◽  
Hanoon Pokharel

Introduction: Cervical cancer is the most common Gynaecological cancer in Nepal which is preventable if appropriate screening and prevention measures are employed. Considerable reduction in cervical cancer incidence and cervical cancer related deaths can be achieved by effective screening. However, lack of knowledge and awareness can result in underutilization of the preventive measures.  Objectives: The objective of this study was to assess the knowledge and attitude regarding cervical cancer screening in women visiting Obstetrics and Gynaecology OPD at tertiary care Hospital in Eastern Nepal.  Methodology: A cross-sectional questionnaire-based study was conducted in Obstetrics and Gynaecology outpatient department of Birat Medical College Teaching Hospital from 1 January 2019 to 31 December 2019. Women were enrolled in the study by convenient sampling methods. Structured questionnaire was used to collect the data. The collected data was entered in Microsoft excel and analyzed by using SPSS version 22.  Results: Among 374 participants, the mean age was 31.13 years. More than three fourth (89.6%) of participants were literate. Regarding occupation, 89.8% of participants were housewives, and 82.9 % of participants were married. As per the findings, only 43.27 % of participants i.e. less than the mean, had adequate knowledge of cervical cancer and its screening. 65.50 % of participants had a negative attitude towards cervical cancer screening. Literate participants had good knowledge and positive attitude regarding cervical cancer screening than illiterate participants (P value less than 0.05).  Conclusion Considerable proportions of participants had inadequate knowledge and negative attitude regarding cervical cancer screening in Gynaecological patients visiting tertiary care Hospital in Eastern Nepal.


2016 ◽  
Vol 28 (1) ◽  
pp. 31-37
Author(s):  
Nahid Yusuf ◽  
Md Ahmed Ali ◽  
Md Latifur Rahman ◽  
Hasina Akhter ◽  
Jahanara Khanam

Introduction: Visual inspection of cervix after application of 3-5% acetic acid (VIA) is a potential alternative to Pap smear cytology for screening of cervical cancer in resource poor settings. VIA has gained popularity and proven itself in many clinical trials as an adequate screening test. VIA is an attractive alternative to Pap smears for its ease of use, low-cost and fewer physician visits. Currently VIA is done in tertiary level hospitals by trained health care providers to generalize its efficacy.Objective: The main objective of this study was to evaluate the efficacy of visual inspection based screening approach in the detection of precancerous & early cancerous lesions of the cervix.Materials and Methods: This study was done as a part of an ongoing screening program in Rajshahi Medical College Hospital from July 2008 to December 2009. VIA was carried out in 540 eligible women attending Gynae OPD for gynecological problems. The women underwent a complete clinical evaluation. Detection of well-defined, opaque, acetowhite lesion close to squamocolumnar junction (SCJ) or in transitional zone (TZ), well-defined circumferential, acetowhite lesions or dense acetowhitening of ulceroproliferative growth on the cervix constituted a positive VIA. All screened women evaluated by colposcopy and biopsy were taken from colposcopically suspected areas or in cases of VIA negative from different quadrants of the cervix. The final diagnosis was based on histology, which allowed direct estimation of sensitivity, specificity, and predictive values of VIA. Those with CIN I or cancerous lesions diagnosed by histology were considered as true positive.Results: Out of 540 patients screened, 328(61%) were VIA negative and 212(39%) were VIA positive. Out of positive cases 87 (41%)%) seemed to have pathology. Colposcopy yielded normal results in 340 (63%) cases, low grade CIN in 138 (26%) cases, high grade CIN in 44 (8%) cases and cancer in 18 (3%) cases making total 200 cases. Of the 200 (37%) patients with positive colposcopy, 98 (49%) turned out to be negative on histology. There were biopsy proven chronic cervicitis and metaplastic changes in 423 (78%) cases, CIN I in 66 (12%) cases, CIN II in 25 (5%) cases, CIN III/ carcinoma-in-situ in 5 (1%) cases. Eighteen (3%) cases of cervical carcinoma were diagnosed on colposcopy but ultimately 21(21%) cases of invasive cancer were detected on histology. The sensitivity of VIA for biopsy proven CIN I was 74.36%, specificity 75.8%, positive predictive value 41.04%, & negative predictive value 90.85%.Conclusion: VIA can differentiate a normal cervix from a precancerous cervix with reasonable accuracy. Till now a good number of studies had been carried out in different countries of the world and now it is well established that the sensitivity of VIA equaled or exceeded the reported rates for conventional cervical cytology. As it is low cost and simple method, it can be set in any hospital or any health care centre of rural or urban areas of poor resource settings.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 31-37


2018 ◽  
Vol 10 (1) ◽  
pp. 36-41
Author(s):  
Lutfa Begum Lipi ◽  
Afroza Kutubi ◽  
Mohammed Mizanur Rahman ◽  
Nebedita Shaha ◽  
Nazma Haque ◽  
...  

The purpose of this study was to assess the knowledge and awareness regarding cervical cancer and its prevention among women attending at out patient department of Dhaka Medical College Hospital. A qualitative study was undertaken using face to face in depth interviews from January 2015 to July 2015 .Among 229 women mean age 34.07±7.92 ,from 18 to 60 years were observed. Awareness and knowledge about cervical cancer was very poor which was about 25.3%. Knowledge was high among women coming from high socioeconomic condition which was 31.5% (p=0.03). Participants who were highly educated had more knowledge about 83.3% (<0.001). Most of the participants about 72.22% got the information from doctors and health service providers. The findings highlights the importance of awareness creation about cervical cancer and its risk factors, screening through utilization of the services of media like television, newspaper and radio which have massive impact in improving the knowledge.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 36-41


2015 ◽  
Vol 14 (2) ◽  
pp. 57-60
Author(s):  
Fahmida Shirin Papri ◽  
Zubaida Khanam ◽  
Fahmida Islam ◽  
Md Monjurul Hakim

Cervical cancer is one of the leading causes of morbidity and mortality amongst the gynaecological cancer in Bangladesh.This study was carried out to assess the knowledge of cervical cancer, awareness of the women towards the cervical cancer screening program and its vaccination in Bangladesh. A cross- sectional interview based study was conducted using a self administered questionnaire between January 1 ,2013 and June 31, 2013 on 508 respondents. Convenience sampling was applied among the women attending at Gynae Out Patient Department (GOPD) of Chittagong Medical College Hospital for VIA (Visual Inspection with Acetic Acid) test. Of the 508 respondents only 211(41.54%) told that they had idea about cervical cancer, while only 114 (22.44%) knew that VIA is the screening test for cervical cancer.A total of 390 (76.77%) respondents did not know any cause of cervical cancer.Most of the respondents (80%) came for VIA due to doctor’s advice.After doing VIA among 229 respondents, 149 (65.07%) told that they had been counseled for the next follow - up by the health professionals and 118 (51.52%) were ready for routine periodic screening.Majority (85.88%) of the respondents were absolutely ignorant about the vaccine of cervical cancer. Age and marital status did not influence their knowledge but the level of education and occupation was found to positively influence their knowledge of cervical cancer and their acceptance of the screening test.This study highlights that majority of women in Bangladesh are not adequately equipped with knowledge concerning cervical cancer. Adequate health information and counseling on cervical cancer and regular screening test need to be emphasized in our country.Chatt Maa Shi Hosp Med Coll J; Vol.14 (2); Jul 2015; Page 57-60


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