ABSTRACT
Cancer of the uterine cervix is one of the leading causes of cancer death among women worldwide. The estimated new cancer cervix cases per year is 500,000 of which 79% occur in the developing countries. Cancer cervix occupies either the top rank or second among cancers in women in the developing countries, whereas in the affluent countries cancer cervix does not even find a place in the top 5 leading cancers in women. The truncated rate (TR) in the age group 35-64 years in Chennai, India, is even higher (99.1/100,000; 1982-95) than rate reported from Cali, Colombia (77.4/100,000, 1987-91). The cervical cancer burden in India alone is estimated as 100,000 in 2001 AD. The differential pattern of cervical cancer and the wide variation in incidence are possibly related to environmental differences. Aetiologic association and possible risk factors for cervical carcinoma have been extensively studied. The factors are: Sexual and reproductive factors, socio-economic factors (education and income), viruses e.g., herpes simplex virus (HSV), human papillomavirus (HPV), human immunodeficiency virus (HIV) in cervical carcinogenesis and other factors like smoking, diet, oral contraceptives, hormones, etc. The accumulated evidence suggests that cervical cancer is preventable and is highly suitable for primary prevention. Sexual hygiene, use of barrier contraceptives and ritual circumcision can undoubtedly reduce cervical cancer incidence. Education, cervical cancer screening of high risk groups and improvement in socio-economic status can reduce cervical cancer morbidity and mortality significantly.
Subject(s)
Adenocarcinoma/etiology , Adult , Carcinoma, Squamous Cell/etiology , Cause of Death , Cross-Sectional Studies , Developing Countries , Female , Humans , Incidence , India/epidemiology , Middle Aged , Risk Factors , Uterine Cervical Neoplasms/etiologyABSTRACT
The utility of data collected on patients will be rendered insignificant without adequate follow-up information. Efficient methods should be used to follow cases in order to get vital status information in Hospital(HBCR) and Population Based Cancer Registries (PBCR). Based on our experience we have evolved methods to follow cancer cases and this has been discussed in this paper. Active follow up of cases has enhanced follow-up rate from 50% to more than 85% at HBCR and "death in period" from 19% to 41% during the period 1982 to 1991 in PBCR. Active follow-up is mandatory for the cases registered at HBCR. In addition to collecting data from VSD on cancer deaths, active follow-up is desirable to get maximum death information on cases registered at PBCR in a developing environment. Computerization of follow-up data is necessary in order to further improve the efficiency of the follow-up system.