Detection of Cervical Cancer through Visual Inspection of Cervix with Acetic Acid (VIA) and Colposcopy at Mymensingh...

Cervical cancer is the second most common cause of cancer related morbidity and mortality in women with 50% mortality rate. It is preventable if cervical cellular changes are detected and managed at early stage. This was a retrospective study conducted at VIA center of outpatient department and Colposcopy clinic at in-patient department of Mymensingh Medical College Hospital, Bangladesh covering a period from September 2013 to November 2014. Objective of this study was detection of cervical cancer and precancerous condition amongst patients reported to VIA center and Colposcopy clinic. In primary screening at VIA Center, total respondents were 3604, their mean age was 35.9 and highest were in the age group 31 to 40 years. At VIA center, 110(3.05%) were found positive and highest were between 31 to 40 years. In Colposcopy Clinic, out of 700 patients, 51.7% were CIN 1, 4.9% CIN 2, 1.4% CIN 3, invasive carcinoma was 0.3% and unsatisfactory or inconclusive were 34.3%. Most of the respondents were housewives and majority had poor monthly income. Amongst respondents, 72.1% were from rural area and Colposcopic findings revealed in 62.5% abnormal cervical changes, 46.5% were from rural area. Mean age at marriage or age at first coitus was found 16.25 years and 92.7% were in 11 to 20 years. Maximum abnormal cervical findings including CIN were between the ages ranged from 11 to 20 years of marriage age. In patients having 1 - 5 number of child having abnormal (58%) cervical changes, 48% were CIN 1. Histopathology reports found 19.6% CIN 1 (Total CIN 20.7%), cervical carcinoma 1.3%, inflammatory 7.0% and 0.42% cases were reported normal. Amongst 438 histopathology advised cases, 230 respondent's reports with patients were not available. VIA followed by Colposcopy has been a feasible, easy and reliable tools for screening cervical cancer in Bangladesh.