Download age difference in cervical neoplasia distribution among women

AGE DIFFERENCE IN CERVICAL
NEOPLASIA DISTRIBUTION AMONG
WOMEN ATTENDING A HOSPITAL
BASED AND PERIPHERAL
SCREENING PROGRAMMES
Dr.Kalavathy Mathurchennath1, Saritha.V.N,
Sujathan.K, Preethy Sara George
1 Assistant Professor, Regional Cancer Centre,
Trivandrum, Kerala, India
Background
• Cervical cancer continues to be the second
common malignancy among females of India and
Kerala, the rate of which is around
8/100,000/year in Trivandrum
• Regional Cancer Centre (RCC), Trivandrum, India,
runs two parallel cervical cancer screening
programmes. One regular pap screening in a
tertiary Women & Children Govt hospital,
Trivandrum(Group1) and second a peripheral
screening programme in different Govt Primary
Health Centres (PHC) of Trivandrum (Group2)
Objective
• To see the difference in incidence and age
distribution of cervical neoplasia among
women attending hospital based and
peripheral screening programmes
Methodology
• Hospital based screening programme
conducted regularly twice in a week in the
Govt Women & Children Hospital, Tycaudu,
Trivandrum
• Women attending the Gynaec OPD are
subjected for routine pap Smear examination
Methodology …..cont..
• Peripheral screening programmes are
conducted in 1-2 Govt PHCs in a week. All
PHCs in the district are expected to be covered
within a period of 18 months.
• The women for the Pap Smear screening are
motivated by the Accredited Social Health
Activist (ASHA) female workers.
Methodology.. Cont…
• For both Group1 and Group2, the Pap Smear
collection is done by the same team of health
staff from RCC.
• Socio demographic details of each woman
subjected for Pap smear is collected as a
routine in all the cases.
Results
• Data of a total of 4991 women from Group1
and 3033 from Group2 were analysed
• .32% of Group1 and .36% of Group2 had Low
grade Squamous Intraepithelial Lesions (LSIL)
• The mean age of incidence of LSIL was 45 in
Group1 and 44 in Group2
Results ..cont..
• The incidence of Highgrade Squamous
Intraepithelial Lesions (HSIL) was 1.1% in
Group1 and .32% in Group2.
• The mean age of incidence of HSIL was 54.65
in group1 and 43.3 in Group2 and this
difference was statistically significant (p
value .014)
Discussion
• The almost same LSIL incidence in both groups is
expected and the mean age of incidence is also same
• The hospital group has a higher incidence of HSIL as it
expected from a high risk group.
• The mean age of incidence of HSIL is significantly lower
among the peripheral screened population . This has a
great public health importance as it helps to detect
asymptomatic women with HSIL who have never been
to a hospital at an early age and get treated and arrest
the development of cervical cancer