European Journal of Biomedical and Pharmaceutical Sciences

CERVICAL CANCER SCREENING IN RURAL VILLAGES OF NEPAL: ITS CHALLENGES, PREVENTION AND EFFECTIVENESS OF CONDUCTING FREE HEALTH CAMPS

Sushna Maharjan*

ABSTRACT

Introduction: Cervical cancer is ranked 1st among women in Nepal. A number of socioeconomic, cultural, ethical challenges, geographically difficult terrain of Nepal and insufficient health care resources are associated with ineffective cervical screening programs in Nepal. There is very low (2.8%) coverage rate for cervical cancer screening services in Nepal. Thus, we need to address these challenges for successful implementation of screening programs and prevent women from cervical cancer. This study was undertaken to find out incidence of precancerous lesions/cancers of cervix in women living in remote villages of Nepal where health care resources are limited and observe the effectiveness of free Pap smear cervical screening programs. Materials and methods: A prospective, cross sectional study was conducted in married women attending free health camps for cervical screening carried out in 2016 at three different remote regions of Chitwan district, Nepal on three different periods. Samples were processed at Chitwan Medical College and reported by using the 2001 Bethesda System1 of reporting Pap smear cytology. Analysis of data was done by using SPSS 16. Results: Among 1108 cases, majority (966, 87.2%) were in 21-50 age group. We observed 1% abnormal cytology, 0.5% (5) low grade and 0.5% (5) high grade lesions. Most (80%) high-grade lesions were in 41-50 age group. Age group of 30-65 years covers four-fifth of the samples (880, 79.4%), and 91.8% (45/49) of abnormal cytology. Cervical carcinoma (Squamous cell carcinoma) was found in 0.1% cases on histopathological examination of colposcopic biopsy. Conclusions: It indicates cervical screening and early treatment are vital to prevent cervical cancers. Special free cervical screening camps should be conducted to reduce burden of cervical cancer in rural areas. Barriers should be addressed by government for proper implementation of cervical screening policy.

Keywords: Abnormal, cancer, cervix, Pap, screening.