Published: 2021-03-24

Epidemiology of pre invasive and invasive lesions of the cervix at tertiary health centre in Punjab

Garima Bhardwaj, Amritpal Kaur, Permeet Kaur Bagga


Background: Cervical cancer is the fourth most frequent cancer in women globally, next to breast, colorectal and lung cancer and it is also the fourth most common cause of cancer death in women. According to the Indian council of medical research (ICMR), in India one woman dies of cervical cancer every 9 minutes. This study used PAP smear and histopathology to find out about the epidemiology of pre invasive and invasive lesions of the cervix at tertiary health centre in Punjab and their correlation with various social and demographic features.

Methods: This prospective clinical study was carried out in the Department of Obstetrics and Gynaecology in Amritsar Medical College from May 2018 to April 2020, after taking approval from the Institutional Ethical Committee. The study selected 500 women randomly among the patients attending the Gynaecology OPD who met the inclusion criteria. Detailed history and PAP smear was taken at first visit followed by cervical biopsy amongst women with abnormal cytology report or with frank lesions of cervix.

Results: Out of 500 women included in the study, majority of women (82.5%) were Negative for intraepithelial lesion or malignancy (NILM), 4% women had Atypical squamous cells of undetermined significance (ASCUS), 6.1% had low grade squamous intraepithelial lesion (LSIL) and 16 (3.2%) had High grade squamous intraepithelial lesion (HSIL). Amongst the histopathology reporting 15.62% patients had cervical intraepithelial neoplasia 1 (CIN I), 6.25% patients had cervical intraepithelial neoplasia II (CIN II), 3.12% patients had cervical intraepithelial neoplasia III (CIN III), 6.3% patients had squamous cell carcinoma and 3.1% patient had adenocarcinoma of cervix. Age, low level of education, poor socioeconomic status, early marriage and multiparity are the risk factors found to be associated with pre invasive and invasive lesions of the cervix. (p<0.001).

Conclusions: Though infection with human papilloma virus (HPV) is essential for the development of the disease, there are other high-risk factors like age, poor education, low socioeconomic status, early age at marriage and high parity which are significantly associated with the occurrence of the disease. Therefore, our primary and secondary preventive measures must include the women who come under these high-risk categories. 


Human papilloma virus, NILM, LSIL, HSIL, CIN, SCC

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