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Screening for cervical cancer by direct inspection
V Singh1, A Sehgal, U K Luthra
1Institute of Cytology and Preventive Oncology (ICMR), Maulana Azad Medical College, New Delhi, India.
BMJ (Clinical Research Ed.)
|February 29, 1992
Summary
Visual screening for cervical cancer in maternal health settings can identify high-risk women effectively. This method aids early detection, especially where advanced screening is unavailable.
Area of Science:
- Oncology
- Public Health
- Gynecology
Background:
- Cervical cancer screening is crucial for early detection and treatment.
- Visual inspection methods offer a potential alternative in resource-limited settings.
- Maternal and child health centers serve a large population of women.
Purpose of the Study:
- To evaluate the effectiveness of visual screening for cervical cancer.
- To compare visual screening with cytological methods in a maternal and child health context.
- To determine the prevalence of early-stage cervical cancer among high-risk women identified visually.
Main Methods:
- A study involving 44,970 women was conducted at maternal and child health centers in Delhi.
- Both clinical visual examination and cytological screening were employed.
- Data were collected from May 1988 to March 1991.
Main Results:
- 238 early-stage cervical cancers (stages 0-IIa) were detected cytologically and confirmed by biopsy.
- The prevalence of cancer in women identified as high-risk via speculum examination was 29/1000, compared to 1.53/1000 for those with a normal cervix.
- Although only 11.4% of women were classified as high-risk, they accounted for 63% of early-stage cancers detected.
Conclusions:
- Visual screening, while less optimal than cytology, can be valuable for cervical cancer detection.
- It is particularly useful in areas with a high burden of prevalent cancer and limited access to cytological screening.
- Targeting women with bleeding symptoms as high-risk could improve cancer detection yield significantly.