Association of Clinical Presentation at Different Stages of Carcinoma Cervix

ABSTRACT

Background: Cancer cervix is the most common cancer in women in developing countries where screening facilities are inadequate. The incidence of cervical cancer is steadily declining in the developed world. The rate of cervical cancer is decreasing day by day due to their awareness of cervical cancer, especially its risk factors, and undertaking measure like routine screening tests. It may present with vaginal bleeding but symptoms may be absent until the cancer is in its advanced stage. This study aimed to analyze the association of clinical presentation at different stages of carcinoma cervix. Material & Methods: This descriptive study was conducted in Chittagong Medical College Hospital, taking 100 randomly selected patients of carcinoma cervix over one year (July 2019 to June 2020). The research protocol was approved by the research committee (Local Ethical committee). Informed written consent was taken from each patient. Results: Among the study subjects, most of the respondents (32, 32.0%) belonged to 51-60 years old followed by (24, 24.0%) 41-50 years and >60 years of age. Most (76, 76.0%) of the patients presented with blood-stained vaginal discharge. Significant numbers of the patient presented with foul smelling per vaginal discharge (72, 72.0%) and post-coital bleeding (68, 68.0%). Only 8% of the patients had haematuria signifying the advanced stage of the disease. Most of the patients about 72.0% sought medical advice within one year of developing symptoms. 56.0% of patients were menopausal, only 20.0% of patients had regular menstruation, and 24.0% of patients had irregular menstruation. 24.0% of patients had metrorrhagia and 2.0% of patients had dysmenorrhoea. Some degree of anemia was present in almost all patients. Only 16.0% of the patients had severe anemia 6.0% of the patients had dependent edema and 4.0% had lymphadenopathy. Most of the patients had cauliflower-type (54.0%) lesions in the cervix followed by 36.0% of patients who had the ulcerative type of growth in the cervix. Among the respondents, 96.0% of the patients had squamous cell carcinoma and only 4% had adenocarcinoma. Most (44, 44.0%) of the patients presented in the hospital with stage II ca cervix, followed by stage III (40, 40.0%). Conclusion: Most common presentation was blood-stained per-vaginal discharge, followed by foul-smelling per-vaginal discharge and post-coital bleeding. All the patients were clinically anemic, some showed severe anemia. The majority of the patient in this series showed a cauliflower-like lesion, followed by an ulcerative lesion. Among all patients majority (96.0%) had squamous cell carcinoma and the remaining had adenocarcinoma. Most of the patients presented in the hospital with stage II ca cervix, followed by stage III.