Cervical Cancer Screening in Pregnancy and Postpartum: A North Indian Hospital Based Prospective Observational Study

Poonam Gill,Sandipan Chowdhuri,Aanchal Agarwal,Om Kumari,Anupama Bahadur,Jaya Chaturvedi,Kavita Khoiwal,Amrita Gaurav

doi:10.31557/apjcb.2020.5.3.99-106

Poonam Gill, Sandipan Chowdhuri + Show 6 more

Open Access

https://doi.org/10.31557/apjcb.2020.5.3.99-106

Copy DOI

Abstract

Introduction: In India, cervical cancer stands as the 2nd most common female cancer and it is the 2nd most leading cause of deaths in women aged 15 to 44 years. The first visit to the gynecologist for most of the women in India is during pregnancy, thereby making it a fair opportunity for the screening of premalignant and malignant cervical disease. Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, AIIMS, Rishikesh, Uttarakhand, India from January 2018 to January 2019. The Pap smear testing of 237 spontaneously conceived antenatal women, aging between 20 to 35 years was performed. The same women were followed up for postnatal testing after 6 weeks of delivery. Results: Out of 237, 8 women were reported positive for pre malignant lesions of cervix in the antenatal testing, 5 cases of ASCUS, 1 case of AGC, 1 case of ASC-H & 1 case of HSIL. In the postnatal Pap smear testing, 37 women were lost to follow-up including 1 case of ASCUS. Postnatal Pap smear testing of the remaining 200 women showed that 193 women who were reported NILM in the antenatal period remained unchanged in the postnatal screening too. Out of the 7 women who tested positive, 4 cases of ASCUS, 1 case of AGC and 1 case of ASC-H showed regression, giving result as NILM in the postnatal screening test. Out of the 7 positive antenatal tests, 1 case which was reported as HSIL in the antenatal screening, remained unchanged in the postnatal period.Conclusion: The study concluded that there is significant regression (p<0.01) of Positive Pap smear findings from antenatal to postnatal period. Hence, it is imperative to repeat Pap smear test in postnatal period.

Highlights

In India, cervical cancer stands as the 2nd most common female cancer and it is the 2nd most leading cause of deaths in women aged 15 to 44 years
Global incidence and mortality rate of cervical cancer depend upon the presence and effectiveness of screening programs for pre-invasive and invasive lesions of the cervix and human papilloma virus (HPV) vaccination
Antenatal women with age less than 20 years or more than 35 years, history of medical disorders like hypertension, diabetes mellitus with vasculopathy, renal disease, anti-phospholipid antibody syndrome & chronic anemia and maternal or paternal history of small for gestational age were excluded from the study

Summary

Introduction

In India, cervical cancer stands as the 2nd most common female cancer and it is the 2nd most leading cause of deaths in women aged 15 to 44 years. Crude incidence rate of cervical cancer in the world is 15.1 per 100,000 per year and is 14.9 per 100,000 per year in India It is the 2nd most common malignancy in Indian females (commonest being Carcinoma Breast) and the 2nd leading cause of death in women aged between 15 to 44 years. Global incidence and mortality rate of cervical cancer depend upon the presence and effectiveness of screening programs for pre-invasive and invasive lesions of the cervix and human papilloma virus (HPV) vaccination Due to these interventions, there has been a 75% decrease in the incidence and mortality of cervical cancer over the past 50 years in developed countries [2,3,4]

Methods

Results

Conclusion