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Year : 2022  |  Volume : 2  |  Issue : 1  |  Page : 14-18

Cost-effectiveness of cervical cancer screening in rural Bengaluru with demographic analysis of epithelial cell abnormalities: A cross-sectional descriptive study

1 Department of Pathology, The Oxford Medical College, Hospital and Research Centre, Bengaluru, Karnataka, India
2 Sahaya Hastha Trust, Bengaluru, Karnataka, India
3 Director, The Oxford Medical College, Hospital and Research Centre, Bengaluru, Karnataka, India
4 Chairman, The Oxford Medical College, Hospital and Research Centre, Bengaluru, Karnataka, India
5 Centre for Academic Research, HCG Cancer Center, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Amrit Kaur Kaler
Consultant Molecular Pathologist, Department of Laboratory Medicine, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpo.jpo_5_22

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Aim: Cervical cancer is the fourth-most common cancer in women worldwide and ranks third among all the malignancies for women. In contrast to developed countries, cervical cancer is a public health problem in developing countries like India and accounts for a quarter of the global disease burden. It is also one of the leading causes of cancer mortality in India, accounting for 17% of all cancer deaths among women aged between 30 and 69 years. The aim of this study is to perform a demographic analysis of cervical cancer by using Papanicolaou (PAP) test as a screening modality in Doddaballapur, rural Bengaluru, Karnataka. Materials and Methods: A cross-sectional descriptive study was conducted on cervical cancer screening utilizing PAP smear screening. Camps were organized in Doddaballapur, rural Bengaluru, organized by Non-Profit Organization, Sahaya Hastha Trust between December 2017 and 2018. The PAP smears were stained and evaluated for epithelial cell abnormality using Bethesda System criteria free of cost at The Oxford Medical College and Hospital, Bengaluru. Results: A total of 647 patients were evaluated in this prospective study and abnormal epithelial cell abnormalities (ECA) were observed in 24 (3.7%) cases. Among the 24 cases, 2 cases (8.3%) of squamous cell carcinoma, 11 cases (45.8%) of atypical squamous cell of undetermined significance, 5 cases (20.8%) of Atypical Squamous cells - cannot rule out high-grade squamous intraepithelial lesion (HSIL), 3 cases (12.5%) of low-grade squamous intraepithelial lesion (3), 2 cases (8.3%) of high-grade squamous intraepithelial lesion (HSIL), and a single case (4.2%) of atypical glandular cells of undetermined significance were noted. Of the remaining 623 smears (96.2%) diagnosed with negative for intraepithelial lesion or malignancy, 428 cases (68.7%) were reported as nonspecific inflammation, while 56 smears (8.9%) showed atrophic smears and 20 cases (3.1%) were unsatisfactory for evaluation. 119 cases (19.1%) displayed a specific infectious etiology; coccobacilli (bacterial vaginosis) being the most common 66 cases (55.5%), followed by Trichomonas vaginalis 46 cases (38.6%) and Candida infection has 7 cases (5.8%). Conclusions: In Dodabullapur, a rural Bengaluru suburb, 3.7% of cervical cancer patients had ECA. It is hypothesized that a low-cost screening program is exceptionally beneficial in lowering the disease burden of cervical cancer, especially among middle-aged women and those living in low-income areas. This humanitarian purpose might motivate women in rural regions to be educated with the sole goal of uplifting the impoverished.

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