Evaluation of Cervical Cancer by Colposcopy and HPV-DNA in President Abdul Hamid Medical College, Kishoreganj

Abstract

Introduction: Cervical cancer, a significant public health issue, necessitates reliable diagnostic strategies for early detection and management. In the pursuit of effective cervical cancer screening strategies, the integration of colposcopy and HPV-DNA testing is critical, especially in high-risk populations. The study evaluates the diagnostic efficacy of these methods in patients presenting with symptoms indicative of potential cervical malignancy. Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynecology, President Abdul Hamid Medical College and Hospital, Kishoreganj, Bangladesh. The study included a total of 82 participants collected over a 1-year period from July 2022 to June 2023 following the inclusion and exclusion criteria. Patients with VIA Positive diagnosis, abnormal pap-smear results, contact or abnormal per-vaginal bleeding, foul-smelling per-vaginal discharge, and an unhealthy cervix were included in the study, while currently pregnant women, nulliparous, and postmenopausal women, patients with cervical or vaginal growths, and non-cooperative patients were excluded from the study. Result: The mean age of participants was 36.51 years, with most marriages occurring at an average age of 17.07 years. The study identified a high prevalence of multipara status (50.0% had 2-3 children, 36.6% had more than 3). The majority of first deliveries occurred between ages 16 and 22. A significant correlation was found between age and parity (r = .502, p < .01), and a strong association between age of marriage and age at first delivery (r = .815, p < .01). HPV-DNA positivity was 7.3%, while abnormal colposcopy findings (CIN I-III) were observed in 40.7% of cases. Negative correlations were observed between age of marriage and colposcopy findings (r = -.308, p < .01). Conclusion: This study underscores the importance of age, marital history, and parity in the context of cervical cancer screening. The low HPV-DNA positivity rate compared to the higher incidence of abnormal colposcopy findings suggests the need for a combined diagnostic approach. The findings advocate for tailored cervical cancer screening strategies that integrate both colposcopy and HPV-DNA testing, especially in resource-limited settings.