Cervical carcinoma in a Muslim community.

ABSTRACT

OBJECTIVES: The aim of the research was to review the distributions of age, stage at presentation, and morphology of patients presenting with carcinoma of the cervix in a predominantly Muslim population. STUDY DESIGN: This retrospective study was conducted at a comprehensive cancer diagnostic and treatment facility situated in Lahore, Pakistan, reviewing the medical records of the patients. PATIENTS AND METHODS: Four-hundred and nineteen cervical cancer patients were registered at the hospital during a nine-and a half year time period extending from December 1994 to June 2004. Histology was confirmed by exfoliative cervical cytology typically by means of Papanicolaou smear. The International Federation of Gynecology and Obstetrics classification was used to stage the disease. Univariate analysis on factors as age, stage at presentation, and morphology was conducted. RESULTS: 1) The age distribution of the 419 patient cohort was recorded to be as follows mean 49.2 years (SD 11.7, range 11-85 years) and mode 50 years (37 patients). Only one patient was less than 18 years. 2) Of these 419 patients, 73.5% (308/419) had squamous cell carcinoma (SCC), 7.9% (33/419) had adenocarcinoma, and 0.7% (3/419) had adenosquamous carcinoma; of the remainder, 1.4% (6/419) had rare types (3 each of sarcoma and small cell carcinoma) and 16.5% (69/419) had unspecified carcinoma. 3) Only two patients (0.5%) were identified as being in stage 0, 49/419 (11.7%) in stage I, 140/419 (33.4%) in stage II, 90/419 (21.5%) in stage III, 52/419 (12.4%) in stage IV, and 86/419 (20.5%) as not being evaluable. CONCLUSIONS: A large proportion of patients (67%) presented in stages II to IV and only 12% presented early at stages 0 or I. This emphasizes the need for early detection of this tumor in our population. Accordingly, the importance of detection of the pre-clinical stage of the disease by considering the possibility of initiating a cost-effective screening measures needs to be emphasized in our setting.