Carcinoma in Department of Radiotherapy at Pt. B. D.

 

Carcinoma
cervix incidence and mortality have declined in developed world over past few
decades but it still remains to be the most common gynecological cancer. Globally it is  the fourth most common malignancy in women and
seventh overall. Majority
of the global burden (around 85%) is from underdeveloped countries which
accounts for almost 12% of all female cancers. Every year around 7.9% (527,000) new cases of cervical
cancer are diagnosed worldwide and 7.5% (265,000) die of the disease in a year.1
The highest incidence rates of carcinoma cervix are in Eastern Africa,
Southern, Middle and Western Africa while rates are lowest in Western Asia,
Australia, New Zealand and North America.2

Carcinoma
cervix is the second most common cancer in women in India after breast cancer.
Every year approximately one lakh new cases are registered.2
Carcinoma cervix incidence is more among women of lower classes, those less
educated, and those with large number of children. The peak age of carcinoma
cervix incidence in India is 55-59.4 In various cancer registries,
age adjusted incidence rate varies from 4.9 to 30.2 per 100,000 women in India.
The highest incidence is seen in registries from Papumpare, Aizawl district,
Mizoram state, lowest from Dibrugarh.5

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Carcinoma
cervix accounted for 10.3 % of all cancer patients and 27% of all female cancer
patients seen in Department of Radiotherapy at Pt. B. D. Sharma PGIMS, Rohtak
in the year 2015.6

            
Persistent infection with high-risk types of Human Papilloma Virus (HPV)
is the major risk factor for carcinoma cervix. Other risk factors include high parity, history of
sexually transmitted diseases, like gonorrhea, chlamydia, HIV, early age of
first coitus, history of multiple sexual partners or a male partner with
history of multiple sexual partners, family history, cigarette smoking and long
term use of contraceptive pills.

Patients
may remain asymptomatic in early stage of carcinoma cervix. Patients with
advanced disease may present with abnormal vaginal bleeding-postcoital,
menstrual, intermenstrual or postmenopausal. Other symptoms include vaginal
mass, pain during sexual intercourse and serosanguinous or foul smelling
vaginal discharge.

           Approximately 80-90% of all the
cervical malignancies are found to be squamous cell carcinomas, 10-20% are
adenocarcinoma. Squamous cell carcinoma of cervix usually originates at the
squamocolumnar junction (transformation zone) of cervix. Squamous cell carcinoma
most commonly originates from ectocervix and adenocarcinoma most commonly
arises from endocervix.

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