A study of cervical cancer screening for prevention of carcinoma cervix.

ABSTRACT

To identify precursor lesions of cancer cervix and early cancer cervix in married women with primary complaint of leucorrhoea in a tertiary referral centre with reference to effectiveness of screening methods, 100 successive women attending colposcopy clinic with primary complaints of leucorrhoea were selected . All women had speculum examination, Pap smear, vaginal pH, Whiff test, visual inspection of cervix after application of acetic acid (VIA), visual inspection of cervix after application of Lugol's iodine (VIL), colposcopy done. Biopsy was taken when indicated. A total of 63 women were referred. There were 93 menstruating women. The mean age was 34.5 years. Whiff test was positive in 6 women. Downstaging showed 74 women with abnormal cervix. VIA was postive in 44 women and VIL in 53 women. The sensitivity and specificity of VIA was 77.7% and 75%, and that of VIL was 69% and 57% respectively. Diagnostic accuracy of VIA was 76%,VIL was 63%. Pap smear showed 87% accuracy. The correlation between colposcopy and histopathological examination was 93-98%. Precursor cancer cervical lesions, were found in 27% of women. Referral women with cancer precursor lesions formed the largest group of 24% (n=24) of total women. Early carcinoma cervix was detected in 3% (n=3) of which one woman was referred. The burden of carcinoma cervix in India can be brought down by screening camps and early referral.