Colposcopic Findings of Cervix in VIA (Visual Inspection of Cervix by Acetic Acid) Positive Cases at BSMMU, Dhaka, Bangladesh

Abstract

Introduction: Cervical cancer is the most common form of cancer in women in developing countries and the second most common form of cancer in the world as a whole. An estimated 468,000 new cases of cervical cancer and 233,000 deaths occurred in the year 2000. Cervical cancer constitutes about 26 % of female cancer in different areas of Bangladesh. Objective: To find out the role of VIA for the detection of precancerous and early cancerous lesions of the cervix with co-relation of Colposcopic findings and ultimate. Methods: A prospective study was conducted from January, 2010 to June 2010 on 100 women attending at the "Colposcopy Clinic" of Gynae Oncology Division of Department of Obstetrics and Gynaecology of BSMMU, Dhaka. Only VIA positive cases were taken into consideration for the study. Results: The mean age of the participants were 33.39 years (range 18-60) with 41.0 % in the age group between 36-45 years. Among all the subjects, the majority (75%) was housewives and 70.0% the patients hailed from urban area. The yearly incomes of 46% families were between 50,000 to 60,000 Tk. The mean parity of the respondents was 1.75 and 4. More than 4 children were found in 14% cases. Up to 35.0% had 2 children only. About 46.0 % had experienced menarche at the age 13 years and the range was 12-14 years. In regard to risk factors, 64% used hormonal methods. Among the participants 80% experienced first coitus of age between 13-20 years. Excessive vaginal discharge and backache were the principal complaints. Colposcopy evaluated 65 cases as CIN (CIN I 34 %, CIN 11-17%, CIN-III 14%) and 3.0% as invasive lesions. Biopsy evaluated 45% as CIN (CIN I-20% CIN-15%, CIN-III 10%) and 1% as invasive lesions. The sensitivity and specificity of colposcopy were 82.14 % and 50.00% respectively. This suggests the role of colposcopy in the evaluation of CIN and cervical cancer. Conclusion: The study concludes that the VIA and colposcopy are the important methods of diagnostic tools for the diagnosis of cervical pre-malignancy. VIA may be used as a tool for screening in underdeveloped countries and may be associated with a referral procedure for further methods like colposcopy and biopsy. Colposcopy is an indispensable procedure in the evaluation of unhealthy cervix through it requires considerable training and experience.