Correlates of cervical cancer screening among underserved women

Substantial subgroups of Indian women, specifically those of ethnic minorities, had not been screened for cervical cancer or are not screened at regular intervals. We aim to find out the magnitude of cervical cancer and precancerous lesions among women in the age group 15-60 years, and to identify the various socio-demographic and reproductive correlates among those with the cervical lesions.

Nine hundred and sixty-eight adult women in the age group 15-60 years were selected by simple random sampling technique in a population based descriptive cross-sectional study in a cervical cancer screening camp in a primary health center at the East Sikkim, during 1st September to 30th November 2006. Main outcome measures were the extent and correlates of cervical cancer without any interventions. The data collection tool used for the study was a pre-tested questionnaire prepared prior to the study for ensuring feasibility, acceptability, time management, validity and reliability. Information on socio-demographic and reproductive variables was collected by interview method using this questionnaire.

Out of 968 women in the study population, overwhelming majority 921 (95.15%) had no overt or pre-cancerous cervical lesion. Only 47 were found to have changes in their cervical epithelium. None of these 47 women was proved dyskaryotic on cytopathological screening of the cervical smear. No significant difference was noted among those with or without lesions among women below 30 years of age with those above, among illiterate women with literates, in per capita monthly family income difference, age at marriage and childbirth. Low-grade and high-grade squamous intraepithelial cervical lesions were associated with Hindu women only and were related with past history of abortion and still birth in women significantly.

There was an imperative need for identifying prevalence of asymptomatic cervical dysplasia in all population.