Title : A hospital based retrospective analysis of cervical cancer patients attending in a rural medical college in central India
Introduction: Cervical cancer is still major cancer burden in Indian women and it has major impact on their lives .Though the incidence of cervical cancer is decreasing in the developing countries and urban India with the help of proper screening and vaccination, the situation among the rural population is still very gloomy. Barriers to cervical cancer control in rural population include lack of awareness and familiarity with the concepts of prevention and treatment among general population and non-oncologist doctors.
Aim: The purpose of this study was to assess the clinical profile of cervical cancer patients referred to a rural medical college of western India.
Material And Methods: The Data of 1038 patients treated at Radiotherapy Dept of Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra from 1st January,2008 to 31st December 2015, were retrospectively analyzed. Besides, demographical profile patients were evaluated for clinical symptoms, clinical stages, pathology, technique of radiotherapy and compliance to the treatment.
Results: A Total of 1038 patients with the mean age of 52.3 years (ranges 30 – 70years) were studied. Majority of patients ( 540 patients, 52%) presented with vaginal bleeding followed by vaginal discharge (398 patients, 38.3%). On histopathology , 996 patients (95.9%) had squamous cell cancer while rest of the patient had adenocarcinoma. Majority of patients ( 549 patients, 52.9%) had Stage IIIB disease, hence concurrent Chemoradiotherapy followed by brachytherapy( 456 patients, 43.9%) was the most common treatment modality used for our population; only Radiotherapy used for 185 patients(17.8%). 170(16.3%) patient of total population underwent inadvertent hysterectomy without proper staging workup. Compliance to complete full treatment (36% of total patient were non compliant) and for f/u( 68% of total patient were non- compliant) is poor. The follow up data of our study were not adequate due to poor patient compliance, hence could not be presented.
Conclusion: Patients in rural India present at later stages and situation is more worsen with lack of awareness, poor compliance and inadvertent treatment intervention. Hence Awareness among general population should be increased and efforts made to screen pre-invasive and early stage cancers and stat HPV vaccination programme. Physician must exclude the diagnosis of cervical cancer before performing total hysterectomy for abnormal vaginal bleeding.