ABSTRACT
Background: Cancer of the cervix is a leading cause of morbidity and mortality among women worldwide. Therefore, to curb the disease, there is a need to develop a screening test that has good sensitivity and specificity. The aim is to compare the efficiency of Colposcopic Via, Vili, Liquiprep TM and conventional pap smear; as screening procedure for carcinoma cervix.Methods: This study was conducted in 100 women in the reproductive age. The pap smear and VIA are done in these cases. In positive cases, cervical biopsy and histopathological studies are done, the sensitivity and specificity of each test are determined and compared.Results: In this study, more cases belonged to 30 - 45 years age group. Among 100 women, 15% cases had high-grade lesion. Among high-grade lesions group, one case that is 6.7% had CIN 1, 73.3% had CIN2/3 and 3cases i.e., 20% had cervicitis. Among 100 women, 1% had ASCUS result, 10% belongs to HSIL group, 39% belongs to LSIL group and 2% had an unsatisfactory result.Conclusions: The lack of an effective and implementable screening programme lead to reporting of advanced cases of Ca Cervix. If detected at CIN or early Ca cervix stage, effective treatment can be provided with encouraging results. Therefore, effective and implementable Ca Cervix screening need to be provided in our country.
ABSTRACT
Introduction : Ca Cervix is the second most common malignancy in Indian women. Most of the cases present in advanced stage. Radiotherapy is an important modality of treatment. Combination of EBRT and ICRT is an effective strategy which is based on the principle that we are able to give high radiation dose to tumor while sparing surrounding normal tissue.Aim and Objectives :The aim was to evaluate the 3 year overall survival (OS) and disease-free survival (DFS) of patients treated by EBRT and ICRT. The objectives were to evaluate radiation toxicities and to evaluate rate of residual disease, recurrence and distant metastases.Materials and Methods : It is a Retrospective analytical study. We analyzed 468 newly diagnosed cases of Ca Cervix registered in department between January2009 to December2013. Out of which 382 completed radical radiotherapy (EBRT+ICRT).Results : At the end of 3 years 58(15.18%) patients lost to follow-up, 48(12.56%) residual disease, 60(15.70%) local recurrence and 26(6.80%) had distant metastases. The DFS was 73.91% in Stage-I and 62.8% in Stage-II while 51.38% in Stage-III and 29.82% in Stage-IV. The OS was 82.6% in Stage-I, 71.9% in Stage-II, 65.19% in Stage-III and 42.1% in Stage-IV. The difference between early and advanced disease is statistically significant with p-value of 0.016. Conclusions : EBRT and ICRT is effective treatment in terms of overall survival and disease-free survival. Associated radiation induced rectal and bladder toxicities are acceptable & manageable. Early stage and overall treatment time are favorable prognostic factors for 3 year DFS & OS.
ABSTRACT
Background: Cervical cancer still remains a leading cause of morbidity and mortality among women worldwide. Despite attempts to increase screening over the past several decades, incidence and mortality rates of cancer cervix have not shown substantial reduction. The conventional method of screening by cervical cytology/pap smear has failed to reduce the disease burden due to lack of patient compliance for repeated testing and a relatively sophisticated infrastructure. Therefore, alternative methods such as visual inspection after application of acetic acid (VIA), visual inspection with Lugol's Iodine (VILI) and human papillomavirus (HPV) DNA testing have been developed. The aim of present study was to compare Pap smear and VIA and evaluate their usefulness as tools for screening of premalignant and malignant lesions of cervix. Methods: This was a crossectional study over 5 months from 1 Jan 2015 to 31 may 2015 in which 212 patients attending the obstetrics and gynecology department, BHU were enrolled. Pap smear was taken followed by VIA. Pap smears were sent to pathology department, BHU where they were reported as per Bethesda System, 2001. Cervical biopsies were done in positive cases. Data obtained and statistically analyzed. Results: The present study was conducted over a period of 6 months among 212 patients age of 18-60 years screened. Positive results obtained from cytology were 26, VIA was positive in 28 women. Cervical biopsy was done in 34 women who had positive results by either test. Histology in 31 cases was suggestive of cervical intraepithelial carcinoma (CIN). Conclusions: VIA, though less specific has comparable sensitivity to Pap smear and may be used as a primary screening tool for cervical cancer. In combination both the tests have a higher predictive accuracy.