Metropolis optimizes cervical cancer screening

Hyderabad/Mumbai: Cervical cancer is one of the leading causes of cancer deaths among women in India, with approximately 1.32 lakh new cases of cervical cancer being diagnosed and about 74,000 deaths every year. Cervical cancer is predominantly caused by Human Papillomavirus (HPV), a common viral infection, accounting for most cancer deaths in Indian women and the second most common cancer in women worldwide. The good news is that cervical cancer is preventable and is curable if detected early.

January is observed as ‘Cervical Cancer’ awareness month globally and in an effort to spread awareness about cervical cancer screening, Metropolis Healthcare Ltd, “The Pathology Specialist” presents an analysis of screening data collated over two years. Metropolis Healthcare represents an ideal spectrum of Indian women as we receive samples from across the country.

Cervical Cancer and its symptoms

Cervical cancer occurs sequentially from abnormal cells which progresses to grow out of control. When symptoms appear, the disease is usually in its advanced stage. The most common symptoms include abnormal vaginal discharge, unexpected bleeding, bleeding after menopause and pain during sexual intercourse. Having multiple sexual partners, smoking and long term usage of contraceptive pills are the major reasons contributing to the disease.

Screening Recommendations

The latest recommendations from the American Cancer Society for cervical cancer screening are as below

• All women should begin cervical cancer screening at age 21.
• Women between the ages of 21 and 29 should have a Pap test every 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.
• Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
• Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical pre-cancer should continue to be screened.

Screening Methods

Cervical cancer can be screened using different methods:

• Conventional PAP: The Pap test can find early cell changes before they become cancerous. This aids in early treatment
• Liquid based cytology (LBC) PAP Smear: An advanced technique that differs from conventional Pap in way of preparing cervical samples for examination in the laboratory. The biggest benefit of this test to women is that there is no uncertainty in test results or the need for a repeat sample.
• HPV DNA Tests: The HPV (human papilloma virus) test finds certain infections that can lead to cell changes and cancer. HPV infections are very common, and most go away by themselves and don’t cause these problems. The HPV test may be used along with a Pap test, or to help doctors decide how to treat women who have an abnormal Pap test.

In order to understand & compare the effectiveness of two screening methods for Cancer, Metropolis shares the data on 12,603 samples processed from 2012 to 2013.

Total Samples

Age Group	2012			2013			Grand Total
	Conventional	LBC	Total	Conventional	LBC	Total
20 to 30	370	228	598	627	734	1361	1959
30 to 40	723	551	1274	1275	1864	3139	4413
40 to 50	720	476	1196	1294	1460	2754	3950
50 to 60	303	171	474	588	553	1141	1615
60 to 70	95	56	151	186	190	376	527
70 to 80	25	17	42	58	39	97	139
Grand Total	2236	1499	3735	4028	4840	8868	12603

Positive

Age Group	2012			2013			Grand Total
	Conventional	LBC	Total	Conventional	LBC	Total
20 to 30	3	9	12		27	27	39
30 to 40	6	15	21	10	70	80	101
40 to 50	17	21	38	20	71	91	129
50 to 60	10	10	20	9	26	35	55
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