Comparing effectiveness of COBAS HPV test with VIA/VILI, pap smear and colposcopy for screening of cancer cervix

Cancer cervix is the second leading cancer causing 21% of all cancer deaths. Cervical cancer can be prevented if detected by premalignant changes and is curable in its earliest stage. Various procedures including VIA/VILI, pap smear have been routinely used for the purpose of screening cervical cancers. Infection with Human Papilloma virus is the principal cause of cancer cervix. Roche COBAS HPV test was approved by US FDA on April 24, 2014 as one of the first line primary screening method for cancer cervix based on the presence of high risk HPV DNA. The FOGSI guidelines in January 2018 has suggested cobas HPV test for cancer cervix screening. This study was conducted on 100 women with high risk cervical lesions during the period of 18 months. Women attending the NCD clinic of Government Thoothukudi Medical college hospital were taken for the study. The women were to undergo VIA/VILI, Pap smear study and subjected to COBAS HR HPV Test after their consent. Cervical specimens collected in PreservCyt solution using an endocervical brush/ spatula or collected in SurePath preservative fluid using a cervical broom were sent for COBAS HR HPV test. Collected sample kits were recruited in Department of Radiation oncology, Government Thoothukudi medical college for storage at low temperature for a short period, after pooling of samples, these were sent through the Department of radiation oncology to Adayar cancer institute, Chennai, with which the department has treated with for COBAS HPV test. The results were analysed and proceeded.This study has proven that screening for high risk HPV test in cervical specimen can easily pickup the premalignant lesion with high sensitivity, specificity when compared with other screening tests. Hence, this study emphasizes the importance of implementing HPV tests that can provide a 3-year screening free interval, compared to yearly pap screening. The other advantage is that the results are available immediately reducing the frequency of visits to hospital for further follow up on colposcopy/biopsy.

A retrospective analysis of clinical profile of patients with cancer cervix in a rural medical college in Karnataka

Cancer cervix is most common cause of cancerous deaths in females especially in developing countries. The pre-invasive stage of cervical cancer lasts for a long period and a small proportion progresses to an invasive lesion. In Indian set up, majority of the patients are presenting with an invasive lesion. To describe the clinical profile of patients presented with cervical cancer and to describe various treatments received by those patients.: The present study is a retrospective observational study done on confirmed cases of carcinoma cervix who attended rural medical college in Karnataka. Clinical records of the patients, who presented between November 2019 and November 2020 and were diagnosed with cervical cancer, were retrieved. The data related to demographic and clinical variables like age, socioeconomic status, education, symptoms, clinical staging, treatment and histopathology report were recorded. Data collected were entered in Microsoft Excel Office 2007and data analysed. Data were presented using descriptive statistics. The data was expressed in the form of frequencies and percentagesA total of 30 patients with the median age of 46 years were studied. Most common presentation was post coital bleeding (40%) followed by white discharge per vagina in 33%. Majority were under low socioeconomic status (70%). 60% presented in stage II and 30% in stage I. Chemoradiation was treatment of choice in 60% followed by surgery in 33% and 7% were lost to follow up. On histopathology, majority had squamous cell carcinoma (70%).The appropriate management of Cervical intraepithelial neoplasia(CIN) can prevent invasive cervical cancer. In this study most of them presented in advanced stage which could have been prevented with the regular screening and awareness among women in the reproductive age group. : Detection of pre invasive lesions or in situ cases remains important key to decreasing cervical cancer morbidity and mortality.

Assessment of Effectiveness of Acupressure on Chemotherapy Induced Nausea and Vomiting among Women with Reproductive Organ Cancer

Background of the study: Nausea and vomiting are among the most common and distressing symptoms that patients with cancer endure, both as a result of anti – neoplastic treatment and from the disease itself, and significantly affect patients selfcare, coping abilities, and quality of life. Effective management of these individual symptom's response must be there throughout the cancer treatment. Since the acupressure is an easily applicable method regardless of time and place, cost effective, self-controlled and noninvasive method, it can be used to treat chemotherapy induced nausea and vomiting among clients with cancer receiving chemotherapy. The purpose of this study is to assess the effectiveness of non-pharmacological method, acupressure as a treatment modality to relieve nausea and vomiting among patients receiving chemotherapy. Methodology: A quasi-experimental pretest posttest design was adopted. The study sample comprised of 80 women admitted with ovarian cancer and cancer cervix receiving second and third cycle of chemotherapy. Non probability purposive sampling technique was adopted. Self-administered modified Rhode's index scale was administered to the women with reproductive organ cancer receiving second and third cycle of chemotherapy. The level of CINV was assessed by asking the women to indicate the level of chemotherapy induced nausea and vomiting being experienced by them. Results: Findings of this study revealed that acupressure has an effect on the women with ovarian and cervix cancer who were receiving chemotherapy by decreasing the level of CINV. Conclusion: acupressure will be an effective adjunctive in controlling chemotherapy induced nausea and vomiting (CINV) and it can be tried in any oncological setting of clinical practice.

Clinicopathological profile of patients with brain secondaries from Ca cervix: a case series of five patients from tertiary cancer centre in North India

Ca cervix is a common gynaecological cancer in daily practice but secondaries in brain after ca cervix as primary is a rare occurrence. As the survival of ca cervix patients has improved, we are able to encounter secondaries in unusual sites like brain. Prognosis is usually dismal due to presence of extra cranial mets along with brain secondaries which limits the use of new radiotherapy techniques like Stereotactic radiosurgery. We present a case series of five patients who presented to us post radical treatment of cancer cervix and treated with whole brain radiation therapy and best supportive care.

Readiness for cancer cervix control in a North Indian population: Identifying the gaps

Background: Cancer of the cervix is the most common cause of cancer-related deaths amongst women in India. Apart from the availability of healthcare services, awareness and attitude, the cornerstone of public health measures such as screening and vaccination are useful in the control of cervical cancer. There is a lack of studies regarding cervical cancer in the selected region. Objectives: To assess the knowledge of cervical cancer and its associated factors amongst rural women in a densely populated state of Northern India. Methodology: This cross-sectional study was undertaken for a period of one year, i.e., from April 2018 to March 2019, in five randomly selected villages of the Bakshi Ka Talab Block of District Lucknow, Uttar Pradesh. Systematic random sampling was performed to include females aged 15 years and above by a house to house survey. Trained social workers interviewed the consenting participants using a self-structured, pretested and validated questionnaire. The suitable statistical test was used to analyze the data. Results: The majority of the participants (n=300) were aged between 20- 24 years, and the mean age was 28.5 years. Sixty-four per cent of the females were married, and round 43.7% belonged to lower socioeconomic class. Nearly one third reported to have not heard of cervical cancer previously. The knowledge of the various aspects of cancer cervix varied from 3.2% to 55.3%. The most frequently recognized risk factors were early pregnancy (15.7%), giving birth to ≥ 3 children (13.2%) and early sexual initiation (11.7%). Majority of respondents (56.4 per cent) reported weakness to be the most common effect of leucorrhoea. Nearly half of females falsely perceived the actual cause of the leucorrhoea as excess heat in the body. None of the participants had either undergone screening for cervical cancer or had received HPV vaccination despite the availability of healthcare facilities within 30 kilometres. The educational and socioeconomic status were found to be significant predictors of knowledge of cervical cancer on multivariate logistic regression analysis Conclusion: A general lack of awareness has been noted regarding cervical cancer in the study population. None of the participants had undergone screening for cancer cervix or had been administered HPV vaccination, which points to a lack of healthcare utilisation. There is a need to sensitize the target population to the menace of cervical cancer and the usefulness of screening and HPV uptake. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.790-795