Abstrakt

TO STUDY THE PREVALENCE OF PRE-CANCEROUS CONDITIONS OF CERVIX- A HOSPITAL- BASED STUDY

H. K. Cheema

Carcinoma of the cervix is the 3rd most common carcinoma of women. It is a leading cause of morbidity and mortality in India. About 86% of cases occur in developing countries and 88% deaths occur due to cervical carcinoma in developing countries. Pap smear is a simple, non-invasive, cost-effective tool in every Gynaecological OPD which can detect abnormal cytological findings of cervix. It can detect pre-cancerous lesions of the cervix at the earliest and effective early treatment can save women from morbidity and mortality. Aims and objectives of the study were to determine the prevalence of pre-cancerous conditions of the cervix in a hospital-based population in Punjab Institute of Medical Sciences, Garha Road, Jalandhar, Punjab. A hospital-based cross-sectional study was conducted. This was questionnaire-based study. Questionnaire was administered to 500 women attending Gynaecological OPD. The questionnaire consisted of the questions regarding the knowledge and awareness about different aspects of cervical cancer. All relevant socio-demographic parameters, detailed history, clinical examination, per speculum examination and Pap smear cytological study were done. Out of 500 cases studied, 458 cases (91.6%) were satisfactory according to Bethesda System. The epithelial cell abnormalities constituted 42 (8.4%). Maximum no. of cases 210 (42%) were in the age group > 40 years. Co-relation of early marriage/ 1st coitus and increasing age with abnormal cytological findings was statistically significant (p value- 0.001) along with cervical morbidity on per speculum findings. The statistically significant co-relation was found (p value- 0.001) between multiparity (40.7%) and abnormal cervical smear findings. ASCUS was (5.4%) followed by LSIL (1.4%), HSIL (0.8%) and SCC (0.8%). The study clearly shows relatively high prevalence of epithelial abnormalities in cervical Pap smear with increasing age, parity and early age at first coitus in symptomatic women with clinical lesions on per speculum findings. Effective screening with Pap smear definitely helps in early detection of precancerous lesions of cervix. Effective, frequent Pap smear screening programmes should be organised in India, even in the remotest rural areas to prevent the incidence of invasive cervical carcinoma.