Detailed analysis of different risk factors of cervical cancer including HPV infection at different stages of follow up of squamous intraepithelial lesions of cervix (SIL) in rural women

Abstract

Background: As situation regarding carcinoma cervix is still alarming in rural population of India, the management of HPV infection and other risk factors contributing to the development of cervical cancer might play a great role in checking the incidence of the disease. Methods: Rural cervical cancer screening is in progress since May 2013 in the western rural region of Lucknow through camp approach and till date, follow up is available in 264 of the totals 498 Squamous Intraepithelial Lesions of Cervix (SIL) showing regression (204) and persistence of the lesions (60). The risk factors including HPV infection have been studied in detail at different stages of follow up in these two groups. Results: Number of risk factors as obvious showed decline in the regressed cases with subsequent follow up which was lacking in the persistent group. Individually, young age factor showed decline with subsequent follow up while multiparity has been found prominent risk factors in both the groups at all stages of follow up. It was seen that the regression rate was high in women above the age of 30 years with multiparity. The decrease in number of vaginal discharge and erosion cervix cases was also found associated with regression of SIL. Conclusion: The risk factors can predict the biological behavior of SIL towards the progression or regression of the lesions and lead to the better management of any cancer screening program. This will also reduce the follow up burden and treatment costs and will thus enhance the overall acceptability at rural level.