Journal of Epidemiology and Global Health

Volume 10, Issue 1, March 2020, Pages 28 - 35

Cervical Cancer Care Continuum in South India: Evidence from a Community-based Screening Program

Authors
E. Vidhubala1, 2, *, K. Niraimathi2, Hemant Deepak Shewade3, 4, 5, Sankar Mahadevan1
1Nellai Cancer Care Center, Udhavum Ullangal, Tirunelveli, Tamil Nadu, India
2Fenivi Research Solutions, Chennai, Tamil Nadu, India
3International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
4International Union Against Tuberculosis and Lung Disease (The Union), South East Asia Office, New Delhi, India
5Karuna Trust, Bengaluru, Karnataka, India
*Corresponding author. Email: vidhubalae@gmail.com
Corresponding Author
E. Vidhubala
Received 16 March 2019, Accepted 24 July 2019, Available Online 25 November 2019.
DOI
https://doi.org/10.2991/jegh.k.191111.001How to use a DOI?
Keywords
Care continuum; cancer screening; follow-up rate; sort it
Abstract

In India, cervical cancer screening is conducted at various levels; however, after screening, the adherence to the cancer care continuum is barely understood. This study evaluated a community-based cancer screening program conducted in a rural setting (Tirunelveli and Tuticorin districts) in South India and reviewed the completion of care continuum. In this longitudinal descriptive study involving secondary data collection, data from the case records of 2192 women who were consecutively screened between March 2015 and May 2016 were included. All women underwent conventional cytology-based screening (Pap smear) and Visual Inspection with Acetic Acid (VIA). Those for whom either test was positive were referred for histopathological confirmation. Patients with confirmed precancerous conditions and unsatisfactory Pap smears were referred for further management. In total, 2192 women were screened [age range, 17–69 years; mean (standard deviation), 39.2 (8.5)]. Common symptom and sign were white discharge per vaginum (34.9%) and cervical erosion (34.4%), respectively. The VIA was positive for 24% (523/2178; 14 women did not cooperate for VIA) and 113 (5.1%) had epithelial cell abnormality in the Pap smear test. Per histopathology findings, one woman had non-keratinizing squamous cell carcinoma. Seven, three, and four had cervical intraepithelial neoplasia I, II and III, respectively. Of 2192, 807 were eligible for referral (597 had positive results on either Pap or VIA). Among the 807 women referred, only 74 (9.2%) women visited the referral center. The follow-up rate was very poor accounting to fragmentation of care continuum. The success of the screening program depends on the completion of the care continuum.

Copyright
© 2019 Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal
Journal of Epidemiology and Global Health
Volume-Issue
10 - 1
Pages
28 - 35
Publication Date
2019/11/25
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
https://doi.org/10.2991/jegh.k.191111.001How to use a DOI?
Copyright
© 2019 Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

TY  - JOUR
AU  - E. Vidhubala
AU  - K. Niraimathi
AU  - Hemant Deepak Shewade
AU  - Sankar Mahadevan
PY  - 2019
DA  - 2019/11/25
TI  - Cervical Cancer Care Continuum in South India: Evidence from a Community-based Screening Program
JO  - Journal of Epidemiology and Global Health
SP  - 28
EP  - 35
VL  - 10
IS  - 1
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.191111.001
DO  - https://doi.org/10.2991/jegh.k.191111.001
ID  - Vidhubala2019
ER  -