Epidemiological Approach and Precocious Diagnosis of Precancerous Cervical Lesion in Sidi Bel Abbes Region (North-West of Algeria)

Abstract

Object: Cervical cancer of the uterine (CCU) is the first cancer of the genital tract. In Algeria, this cancer remains a real public health problem. The diagnosis is still done often with advanced stages which makes the therapeutic results modest and the cost of the high care. Methodology: Our study aims to elucidate the reality of this type of pathology in the region of Sidi Bel Abbes, northwestern Algeria. This retrospective and descriptive study was devoted to the epidemiological and clinical analysis of cervical cancer cases over a period of 3 years. Results: This study shows that out of a total of 500 smears recorded between (2014-2016) at the Ana-pathology laboratory level in Sidi Bel Abbes, we found that 230 smears presented precancerous lesions according to a cytological study, atypical squamous cells of undetermined significance (ASC-US: were 18%; low-grade squamous intraepithelial lesions (LSIL) were 20%, while high-grade squamous intraepithelial lesions (HSIL) were 8%. The results obtained according to the distribution of the patients in relation to the various factors: the most affected age group is late 46-55 years with a total of 40%; precocious age of 1st report 18-20 years is (38.2%); gestation 4-5 pregnancies and parities 4-5 children with a rate of (38.70% and 32.6%) respectively ; the hormonal state in genital activity is estimated at 62.2%; patients on oral contraception (OC) have a rate of 48.9%. Finally, more than half of the patients (57.8%), were able to have a biopsy within three to four months of the last smear.
 In histology, the presence of a HPV (Human Papilloma Virus) low grade lesion does not predict the evolution of this lesion. Conclusion: HPV can be oncogenic or non-oncogenic. it is the oncogenic HPV infection that is the main risk factor for developing a high grade lesion and cervical cancers outside the associated cofactors.
 Keywords: Pap Smear, Precancerous lesion, Cancer, Cervix, Screening