Background: Carcinoma of the
uterine cervix is a deadly disease, but it is preventable. Cervical cytology
especially at postnatal visit can lead to its early detection and prompt
treatment. Methods: This was a prospective cross sectional study of postnatal
women to determine the prevalence of abnormal cervical cytology and their socio-demographic
characteristics. Patients were recruited from the antenatal clinic and
counseled on the need for postnatal cervical smear. Only those who consented
and met the inclusion criteria were followed up in the postnatal clinic.
Institutional ethical clearance was also obtained. Researcher administered
questionnaire was used to collect the socio-demographic features while Aye’s
spatula and endocervical brush were used to collect specimen from the ectocervix
and endocervix respectively and smeared on individually labeled glass slides.
The samples were treated using the conventional Papanicolaou staining method
and reported using the Bethesda system. Researcher-administered questionnaire
generated data as well as results of cytology were analyzed using Epi-Info
version 3.5.1.0 (CDC Atlanta USA 2008). Colposcopy was done for smear positive
patients. Results: There were 100 women screened. Three percent had low grade
squamous intraepithelial lesion. There were no abnormal findings from the
Colposcopy of the three patients. Ninety-five percent of the women had no prior
knowledge of cervical cancer and Pap smear. Two percent of the women had a
family history of cervical cancer and both patients died of the disease due to
lack of facilities for treatment. Conclusions: Cervical cancer is a preventable
disease but women of the sub-region are under-screened. Postnatal Pap smear is a necessary tool
in its early diagnosis and treatment.
References
[1]
Berek, J.S.
and Hacker, N.F. (2000)
Epidemiology
and Biostatistics of Cervical Cancer. Practical Gynaecologic Oncology, 3rd Edition, Lippincott Williams and
Wilkins, 7, 258.
[2]
Ago,
B.U., et al. (2013)
Cancer
of the Uterine Cervix at the University of Calabar Teaching Hospital, Calabar,
Nigeria. Cancer Research Journal,
1,
37-40.
[3]
Cohn de Herzog, T.J. (2001) New Innovations in Cervical
Cancer Screening. Clinical Obstetrics and
Gynecology, 44, 538-549.
[4]
Adewole, I.F. (2003)
Epidemiology,
Clinical Features and Management of Cervical Cancer. In: Okonofua, F. and Odunsi, K.,
Eds., Contemporary Obstetrics and Gynaecology for Developing Countries, Women’s Health and Action
Research Center, Benin, 289-315.
[5]
Omigbodun, A.O. (2009)
Epidemiology
of Cervical Cancer. Colposcopy Training Workshop, Calabar.
[6]
Omigbodun, A.O. (2010)
Guidelines
for Cervical Cancer Screening. How to Take a Good Pap Smear. Update Course WACS
Abuja.
[7]
Hasanzadeh,
M. and Behtash, N. (2005) Cervical
Cancer Screening. Cancer Therapy, 3, 231-
236.
[8]
Parkin, D.M., Nguyen-Dinh, X.
and Day, N.E. (1985)
The Impact
of Screening on the Incidence of Cervical Cancer in England and Wales. British Journal of Obstetrics and Gynaecology, 92,
150-157.
Disaia, P.J. and Creasman, W.T. (2002)
Preinvasive
Disease of the Cervix. In: Disaia, P.J., Creasman, W.T., Eds., Clin Gynaecol Oncology, 6th Edition, St Louis Mosby Year Book, 1, 1-35.
[11]
Cole, P. and Morrison, A. (1980)
Basic
Issues in Population Screening for Cancer.Journal of the National Cancer Institute, 64,
1263-1272.
[12]
Apgar, B.S., Spitzer, M., et al. (2002)
Colposcopy:
Principles and Practice. An Integrated Textbook and Atlas. Saunders Company, Philadelphia, 52-56.
Rock, J.A. and Jones III, H.W. (2003)
Cervical
Cancer Precursors and Their Management. TeLinde’s Operative Gynaecology, 9th Edition, Lippincort Williams &
Wilkins, 45, 1351- 1373.
[15]
Monk,
B.J. Cervical Cancer Screening.
HPV Resource.org
[16]
Siebers, A.G., et al. (2009) Pap Tests and Liquid-Based Cytology in Detecting
Precancerous Lesions. JAMA, 302,
1757-1764. http://dx.doi.org/10.1001/jama.2009.1569
[17]
Apgar, B.S., Zoschnick, L. and Wright, T.C.
(2003) The 2001 Bethesda System
Terminology. American Family Physician, 68,
1992-1999
[18]
Jain, A.G., Higgins, R.V. and Boyle, M.J. (1997) Management of
Low-Grade Squamous Intraepithelial Lesions during Pregnancy. American Journal of Obstetrics &
Gynecology, 177, 298-302. http://dx.doi.org/10.1016/S0002-9378(97)70190-X
[19]
Vlahos, G., Rodolakis, A., Diakomalis, E., et al. (2002)
Conservative Management of Cervical Intraepithelial Neoplasia (CIN2-3) in Pregnant Women. Gynecologic and Obstetric Investigation,
54,
78-81. http://dx.doi.org/10.1159/000067715
[20]
Paraskevaidis, E., Koliopoulos, G., Kalantaridou, S., et al.
(2002) Management and Evolution of
Cervical Intraepithelial Neoplasia during Pregnancy and Postpartum. European Journal of Obstetrics and
Gynecology and Reproductive Biology, 104, 67-69. http://dx.doi.org/10.1016/S0301-2115(02)00058-1
[21]
Postpartum Care (2006) The Royal Women’s Clinical
Practice Guideline. The Royal Women’s Hospital 2006. www.thewomens.org.au
[22]
Berek, J. and Hacker, N.F. (2000) Berek Practical
Gynaecologic Oncology. Lippincott Williams and Wilkins Publishers, Philadelphia.
[23]
Kwame-Aryee, R. (2005) Carcinoma of the Cervix. In: Kwawukume, E.Y.
and
Emuveyan, E.E., Eds., Comprehensive Gynaecology
in the Tropics, Graphic Packaging, Ghana,
412- 428.
[24]
Hacker, N.F., Berek, J.S., Lagasse, J.D., Charles, E.H., Savage, E.W.
and
Moore, J.G. (1982) Carcinoma of the Cervix Associated with Pregnancy. Obstetrics and Gynaecology, 59,
735- 746.
[25]
Jeronimo, J., Morales, O., Horna, J., et al. (2005) Visual Inspection with Acetic Acid for Cervical
Cancer Screening Outside of Low Resource Settings. Revista Panamericana de Salud Pública, 17,
1-5. http://dx.doi.org/10.1590/s1020-49892005000100001
[26]
Olatunbosun, O.A., Ayangade, S.O. and Okwerekwu, G.A.
(1985) Cytologic Screening for
Cervical Neoplasia in Pregnancy. Tropical
Journal of Obstetrics and Gynaecology, 5,
63-66.
[27]
EL-Gbobasky, A.
and
Herrington, S. (2005) Cervical Cancer:
Epidemiology and Molecular Characteristics. In: Studd, J.,
Ed., Progress in Obstetrics and Gynaecology, Elsevier Science Ltd., Amsterdam, Vol.
16, 323-341.
[28]
Buckley, S.L., Tritz, D.M., et al. (1996) Lymph Node Metastases and Prognosis in Patients with
Stage IA2 Cervical Cancer. Gynecologic
Oncology, 63, 4-9. http://dx.doi.org/10.1006/gyno.1996.0268
[29]
Azodi, M. and Ray, W.
(2003) Premalignant Lesions of the
Lower Genital Tract. In: Okonofua, F. and Odunsi, K., Eds., Contemporary Obstetrics and
Gynaecology for Developing Countries, Women’s Health and Action Research Centre, Benin, 253-288.