Downstaging for cervical cancer: a community-based study in the rural areas of Udupi district, Karnataka, India

Rao, RSP and Kamath, VG and Chandrashekhar, S and Rao, Lakshmi and Kumar, Pratap (2007) Downstaging for cervical cancer: a community-based study in the rural areas of Udupi district, Karnataka, India. TROPICAL DOCTOR, 37 (2). pp. 73-75.

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The objective of this study is to determine the feasibility of utilizing trained auxiliary nursemidwives (ANMs) in downstaging for cancer cervix in a rural area. The study population included all married women in the age group of 35--59 years in two villages of the field practice area. Itwas a cross-sectional study.TwoANMswere trainedin history taking, visual inspection of the cervix, using of speculum and collecting Papanicolaou smears. After training, they made home visits and identified womenwith gynaecological symptoms suggestive of cervical cancer.These women were asked toreport to RuralMaternityand ChildWelfare whom homes where theANMs did a visual inspection of the cervix andmade a cervical smear. Atotalof1402womenwere registeredof the ANMs could identify 368 women (26%) with symptoms. Only192 (52.2%) of these women reported for examination. Chronic cervicitis accounted for the largest proportion of the cases (44.8%). In all, three cases were diagnosed as suspected cases of cancer cervix. On cytology, three cases (1.5%) turned out to bemalignant.When clinical findings of the ANM were compared with results of cytological examination, a high degree of sensitivity (78.4%) and positive predictive value (97.1%) were observed in diagnosing abnormal cytological findings. However, the sensitivity for detecting specific conditions was generally low. Sensitivity for detecting erosionwas 45%, for chronic cervicitis 30%, andmalignancies were totallymissed. In conclusion, this study clearly shows that ANMs, if trained, would be capable of identifying symptomatic women, differentiating a normal cervix froman abnormal one and taking an adequate smear for cytological examination.

Item Type: Article
Subjects: Medicine > KMC Manipal > Community Medicine
Medicine > KMC Manipal > Obstetrics & Gynaecology
Medicine > KMC Manipal > Pathology
Depositing User: KMC Manipal
Date Deposited: 12 Feb 2013 09:55
Last Modified: 12 Feb 2013 09:55

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