Management of abnormal pap smear and pre-invasive disease of the cervix in developing countries
Cervical cancer ranks as the third most common cancer after breast (1.38 million cases) and colorectal cancer (0.57 million cases). In 2008, about 529,000 new cases of cervical cancer were diagnosed globally. This disease is the fourth most common cause of cancer-death (275,000 deaths) ranking below breast (458 000 deaths), lung (427 000 deaths) and colorectal cancer (288 000 deaths). Eighty-six percent of all cervical cancers and 88% of all deaths caused by cervical cancer occur in developing countries.1 In sub-Saharan Africa, cervical cancer ranks the second most common cancer among women. In the year 2012, out of the estimated 370,138 cancers in sub- Saharan African women, about 93,200 new cases of cervical cancer (25.2% of cancers) were recorded. The lowest burden of cervical cancer was reported in Australia, Northern America and Western Europe with an age-standardised incidence rate of 5.0, 5.7 and 6.9/100 000, respectively. The low incidence of cervical cancer in these regions has been attributed to the establishment of an effective cervical cancer screening programme. A strong correlation between the initiation of cytology screening and a reduction in the incidence and mortality from cervical cancer have been demonstrated in countries like Denmark, Finland, Iceland, Norway and Sweden, The introduction of these screening modalities was based on the knowledge that invasive cervical cancer is preceded by an interval of epithelial dysplastic changes, typically occurring at the transformation zone. While the age-standardised incidence rate of cervical cancer in Nigeria has increased to over 30/100 000, much needs to be done to indigenize the experience from these successful screening programmes taking into cognizance the peculiarity of our environment.
The entire contents of the Tropical Journal of Obstetrics and Gynaecology are protected under Indian and international copyrights. The Journal, however, grants to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, perform and display the work publicly and to make and distribute derivative works in any digital medium for any reasonable non-commercial purpose, subject to proper attribution of authorship and ownership of the rights. The journal also grants the right to make small numbers of printed copies for their personal non-commercial use.
This journal content is distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.