Colposcopy attendance in women with High Grade Lesion of Cervix and histological correlation

CERVICAL CYTOLOGY SAVING LIVES ONE CELL AT A TIME

CYTOPATHOLOGY OF CERVICAL SMEAR

The human papillomavirus (HPV) is noted to be responsible for 62.8% of invasive cervical cancers.

Cervical cancer screening test (Pap smear) detects potentially pre-cancerous changes in the cervix

Pap-smear screening can reduce cervical cancer incidence by 60% – 90%

Altogether, screening aims to reduce the mortality rate associated with the disease through the early detection and treatment of abnormalities in the cells lining the cervix.

Treating a woman with an abnormal smear is cost friendly, compared to treating a woman with invasive cancer.

NORMAL VS ABNORMAL SMEAR

THE SOUTH AFRICAN PERSPECTIVE

Cervical cancer is one of the most prevalent cancers amongst South African women and women worldwide. It was found that South African women have a risk of 1 in 31 for developing invasive cervical cancer in their lifetime, and that 60% of them will die from the disease.

In South Africa, women are offered a cervical smear and 30, 40, and 50 years of age.

A study conducted by… showed that only 27.6% of South African women were aware of their HIV status. Therefore, the larger proportion whom are unaware of their HIV status are not receiving HIV treatment and are thus not attending the relevant health screenings.

It was recently announced that every woman who is HIV positive is offered a free smear at the time of diagnosis of HIV.

Women of 25 to 29 years of age carry the highest infection rates with 32.7% of them being HIV infected.

METHOD AND MATERIAL

GSH Cytology Laboratory DISA database was used to search for data on cervical smears which were taken in the year 2012. (insert image)

Participants in this study were women between the ages of 89 and 19 years of age (with 101 years and 4 years of age as outliers)

Only lab numbers were used as identification of patients in this study.

A calculation of the total and age-specific prevalence of women with HSIL identified on cervical smear was done.

The age-specific proportion of women who attended colposcopy was calculated as well as the proportion of non-attendance to colposcopy.

Calculation of correlativity between cytology smears which reported HSIL results against histology colposcopy which likewise reported HSIL results.

OBJECTIVE

To determine how many women in 2012 with HSIL which were identified on a cervical smear were referred for colposcopy at GSH.

To determine how many women who have been referred a colposcopy appointment actually attend colposcopy clinic.

To correlate the cytology findings with the histology colposcopy findings with regards to HSIL.

Slide 4

Proportion of women with HSIL on a smear

referred for colposcopy

22%

78%

other

HSIL

TOTAL NUMBER OF WOMEN REFERRED FOR COLPOSCOPY

CERVICAL SMEARS TOTAL AGE RANGE

HSIL 1703 19-89

ASC-H 222 19-87

CARCINOMA 33 28-84

REFERRAL TO COLPOSCOPY 2180 19-84

RESULTS CERVICAL SMEARS TOTAL

AGE RANGE

HSIL 1703 19-89

ASC-H 222 19-87

CARCINOMA 33 28-84

REFERRAL TO COLPOSCOPY 2180 19-84

THE SOCIAL-PSYCHOLOGY OF COLPOSCOPY

IN CONCLUSION…

South African women still majorly affected by cervical cancer and there is a high non-attendance proportion for colposcopy.

Even though there is a screening programme in place aimed at preventing and reducing the prevalence of HPV infection, more health promotion strategies have to be considered.

The health promotion should take into consideration the psychosocial factors involved in non-adherence to screening of cervical cancer.

Health education is most important of strategies.

With more understanding, women could be less inclined to reject the screening process.