Cervical cancer screening services at tertiary healthcare facility: An alternative approach

Abstract

Introduction: India fights massive cervical cancer burden. This article highlights an innovative feasible approach enabling tertiary hospitals to contribute to cancer prevention without compromising their primary mandate to provide treatment. Methodology: Since 1979, National Institute of Cancer Prevention and Research (NICPR) support a tertiary hospital in cervical cancer screening through a satellite clinic. Record review of 5328 attendees of this clinic between January-December 2016 was done. Pap-smear testing and reporting were performed by trained NICPR personnel. Patients' demographics, reproductive history, Pap-test date, cytology results were recorded and results were communicated to respective units for further management. Results: Among 5328 women screened, 2% (96/5328) had abnormal cytology, which included malignancy(33%; 32/96), Atypical Squamous Cells-Undetermined Significance(ASC-US) (20%; 19/96), Atypical Glandular Cells(AGC) (23%; 22/96) with complaints of pain in lower abdomen 65.6%(59/90), white discharge per vaginum 46.7%(42/90) and backache 23.3%(21/90). In which, Muslims- 67% (65/96), illiterates- 58% (56/96). Age > 35(p < 0.001), parity > 3(p < 0.05), illiteracy (p < 0.05), Muslim women (p < 0.05) had positive association with abnormal cytology. Conclusion: Awareness about cervical cancer screening is the immediate need in resource-limited countries. Government hospitals in such countries should house dedicated preventive oncology unit for cancer screening.