FREQUENCY OF PREINVASIVE CERVICAL LESIONS AND ASSOCIATED RISK FACTORS

Abstract

Objective: To determine the frequency of preinvasive cervical lesions and associated risk factors in asymptomatic women so as to emphasize the need for an organized screening program.

Study Design: Cross sectional epidemiological study

Place and duration of study: Obstetrics and Gynaecology Outpatient Department, Lahore General Hospital Lahore from June2005- May 2006

Methodology: One thousand married women of age 18-60 years were selected after informed consent. Relevant information was recorded on pre designed proforma, Pap smear taken, fixed in 95% ethyl Alcohol and, sent to pathology department. Frequency and predisposing factors were analyzed

Results: About 30% of the cases were lost to follow up. In rest of the cases frequency of preinvasive cervical lesion was 1.25% (33.3% CIN I, 44.5% CIN II, and 22.2% CIN III). Mean age of women with preinvasive lesions were 34yearsand 45% had Parity >7.All of the women with abnormal smears were Muslims, 89% were poor and 78% uneducated. Regarding husband profession about 67% were unskilled laborers while all women were house wives. Mean age at marriage was 18-years and in 45%either or both partners were married twice. 44% of the couples were not practicing contraception. About 33%subjectswere Smokers, None had Pap smear previously and11% had reduced immunity.

Conclusion: Abnormal cervical cytology is linked with multiparity, low socioeconomic status, illiteracy and early age at marriage in this study. Selective cervical screening is essential for high risk population even in under resource settings. Meanwhile alternative cost effective techniques should be evaluated.