Gynaecological Malignancies Among a Representative Population of Batticaloa, Sri Lanka.

Markandu Thirukumar,Ahilan Sinnathurai

doi:10.7759/cureus.12947

Abstract

BackgroundGenital tract malignancies have a significant contribution to morbidity and mortality, particularly in resource-poor countries, including Sri Lanka. The distribution of such tumours varies from region to region. MethodologyThis was a retrospective, observational study at the Teaching Hospital, Batticaloa for five and a half years, from January 2012 to June 2017, and aimed at analyzing the pattern of gynaecological malignancies. All the histologically confirmed gynaecological cancers arising from the uterine cervix, endometrium, ovary, vagina, and vulva were included in the analysis.ResultsThere were 508 cervical specimens to study histopathology of the cervix, 1,884 gynaecological specimens to study the endometrial histopathology, 537 ovarian specimens, and 92 vaginal and vulval specimen were sent for their histopathological study during the same period. About 143 genital tract malignancies had been diagnosed. There were 52 cervical malignancies (36.36%) and 52 ovarian malignancies (36.36%). The second commonest (20.28%) was endometrial malignancy. Vaginal malignancy was at fourth place (4.9%). Vulval malignancy was 2.1%. The peak age distribution of malignancies (55.24%) was mainly in the 40-59 years age range. The incidence of cervical and ovarian malignancies peaked at 40-59 years, with 32/52 (61.54 %) and 26/52 (50%) of the diagnosed cases, respectively.ConclusionCervical cancer and ovarian cancer accounted for almost 72.73% of the entire gynaecological malignancies in this study, and both of them have the same peak incidence in the 40-59 age group. This study also showed that 43.36% of total female genital tract tumours are Human Papilloma Virus-associated cancers. They are not only preventable by certain strategies but also identifiable and manageable at the precancerous stage.

Highlights

Genital tract malignancies have a significant contribution to morbidity and mortality, in resource-poor countries, including Sri Lanka, where poor awareness and late presentation prevail
All the histologically confirmed gynaecological cancers arising from the uterine cervix, endometrium, ovary, vagina, and vulva were included in the analysis
The study showed cervical malignancies contributed 36% of the genital tract malignancies. It was lower than the outcome of the study by Jamal et al in Pakistan, where cervical malignancies accounting for 47% of all gynaecological cancers [8]; 61.5% from Sokoto and 63.1% from Port-Harcourt [9,10]; and studies in Enugu and Maiduguri, where 78% and 70.5% were documented, respectively [11,1]

Summary

Introduction

Genital tract malignancies have a significant contribution to morbidity and mortality, in resource-poor countries, including Sri Lanka, where poor awareness and late presentation prevail. Most of the gynaecological malignancies differ in their frequency and patterns from one region to another. These wide variations in incidence could be because of the health-seeking behaviour of the women and services for organized screening for cervical malignancies, which is the commonest gynaecological malignancy in women worldwide [2,3,4]. Genital tract malignancies have a significant contribution to morbidity and mortality, in resource-poor countries, including Sri Lanka. The distribution of such tumours varies from region to region

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Discussion

Conclusion