Publication:

Delays in reporting of cancer cervix in rural India: sociodemographic and reproductive correlation

Background Cervical cancer, caused by sexually-acquired infection with human papillomavirus (HPV), continues to be a public health problem worldwide as it claims the lives of more than 270,000 women every year. The majority of cervical cancer deaths (85%) occur in women living in low- and middle-income countries. Assessment of socio-demographic profile and reproductive history gives a better picture of the determinants of cervical carcinoma in low-resource settings.

Methods This hospital-based cross-sectional study was undertaken at a Regional Cancer Institute at Aurangabad, India. Hundred newly diagnosed women with advanced cervical cancer (stage 2B-4B), who were undertaking radiotherapy and/or chemotherapy, were included to assess their socio-demographic, reproductive and clinical profile. The causes for late presentations were also noted.

Results The mean age of women at the time of detection of cervical cancer was 57.35 years (30-82 years). More than 81% of patients were illiterate and belonged to low socioeconomic status. 47% of the study subjects had their first sexual experience before 15 years of age. Nearly 78% women had 5 or more pregnancies, among them, unusual discharge from vagina (39%) followed by bleeding after menopause (28%) and pain in abdomen (13%) were the most common presenting complaints. The average duration of symptoms was (28 days), time interval between the symptoms and biopsy was (3.6 months). Combination of radiotherapy and chemotherapy was the most common modality of treatment. Most common cause of delay in diagnosis was lack of awareness about the symptom of cancer (11%), feeling ashamed (10%), no one paid attention (19%), not diagnosed and referred at periphery and financial causes (23%) were found.

Conclusions Prevention of cervical cancer include delaying the age at initiation of sexual activity to above 18 years, spreading cancer awareness in women and with well-equipped health workers with diagnosis and knowledge of cancer cervix. This can prevent the medical and patient delay in the diagnosis of cancer cervix.