Jata Shanker Misra

Abstract

Introduction: This study was undertaken with aim to create awareness among rural women regarding hazards and risk factors of carcinoma cervix and offering single screening for early detection of the disease. This was essential as majority of the rural women were illiterate and have poor personal genital hygiene. Materials and Methods: The present screening program was planned through organizing camps by counseling and motivating 100 women from each village for undergoing Pap smear examination. During last 7 years, a total of 186 camps have been organized in three Blocks of Lucknow, India and 2949 of the 5286 women attending the camps underwent Pap test. findings were analyzed in these 2949 women in relation to different risk factors of the disease. Results: The squamous lesions of cervix (SIL) were seen in 498 cases (16.8%) while atypical squamous epithelial changes of unknown significance (ASCUS) were observed in only 234 (8.2%). The SIL incidence was found high for all risk factors of cervical cancer like young age, and vaginal discharge. Candida was found more common and associated with inflammatory and SIL conditions of cervix. Conclusions: The organization of rural cervical cancer screening programs through camp approach and offering single examination of cervical smears in rural women may prove very effective in the detection of large number of SIL cases, the adequate treatment of which will check the progression of the disease and minimize the incidence of carcinoma cervix and associated mortality in rural India. Keywords: Rural cervical cancer screening, Inflammation, Precancer, Risk factors, STDs, Camp approach.

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Abstract

Introduction: Inflammatory smears are frequently seen in cervical cancer screening and they have been widely implicated as precursor of premalignancy of cervix. In the present study, attempt has been made to find out correlation between inflammation and different predisposing factors to cervical carcinogenesis in the rural context. Materials and Methods: Cervical cancer screening is in progress in the rural population of West Lucknow, India since May 2013 under the auspices of Era’s Lucknow Medical College and Hospital, Lucknow, India and till March 2018, cervical smears of 2563 women have been cytologically examined. Results: The incidence of inflammation was found to be 33.7% in the present series. It was non-specific in 91.3% and was associated with either Candida albicans or Trichomonas vaginalis in 8.2% of cases. The inflammation was associated with low grade squamous intraepithelial lesions of cervix (LSIL) in 176 cases (20.1%) which were mostly asymptomatic (36.1%) and some had cervical lesions on the cervix (11.2%). The inflammatory smears were mostly seen in women complaining of vaginal discharge (47.1%) or vague pain in the lower abdomen (31.9%). The inflammation was more common in younger sexually active women between 21-40 years and was seen rising with increasing parity. Conclusion: The accumulated data points out that the clinical lesions of cervix and multiparity have some impact in the initiation of inflammatory changes in the cervical epithelium. The inflammatory smears, whenever, reported should be adequately treated and smears are repeated after 6 months to rule out any persistence of inflammation or development of any premalignancy. Keywords: Inflammation, LSIL, STDs, Rural women.

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