Department of Pathology, Era's Lucknow Medical College & Hospital, Era University, Lucknow, India.
Department of Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Indian J Med Res. 2018 Dec;148(6):687-696. doi: 10.4103/ijmr.IJMR_5_17.
Cervical carcinoma is one of the most common and dreaded diseases of women, and in India, it accounts for 16 per cent of total cervical cancer cases occurring globally. The situation is more alarming in the rural areas where the majority of women are illiterate and ignorant about the hazards of cervical cancer. Different screening strategies such as rural cancer registries and camp approach for cancer detection have been found useful in minimizing the problem of cervical cancer in the villages. Various screening techniques such as visual inspection with acetic acid, visual inspection with Lugol's iodine, visual inspection with magnification devices-magnavisualizer, Pap smear and HPV-DNA testing have been suggested and tried under low-resource settings of our country, and cervical cytology screening has been found effective in reducing incidence of the disease. In the present review, feasibility of different screening methods has been assessed to find out the most suitable mode applicable at the rural level. Single lifetime screening particularly of high-risk women along with analysis of cost-effective tumour markers such as Argyrophilic nucleolar organizer regions (AgNOR) counts to discriminate high-risk dysplasia cases appears to be an appropriate approach in fighting against cervical cancer.
宫颈癌是女性最常见和最可怕的疾病之一,在印度,它占全球宫颈癌总病例的 16%。在农村地区,情况更加严峻,那里大多数妇女是文盲,对宫颈癌的危害一无所知。农村癌症登记处和癌症检测营地等不同的筛查策略已被证明有助于最大限度地减少农村地区的宫颈癌问题。在我国资源有限的情况下,已经提出并尝试了各种筛查技术,如醋酸肉眼检查、卢戈氏碘液肉眼检查、放大设备-放大肉眼检查、巴氏涂片和 HPV-DNA 检测,并且已经发现宫颈细胞学筛查可有效降低疾病发生率。在本次综述中,评估了不同筛查方法的可行性,以找出最适合农村地区的模式。单一的终生筛查,特别是对高危妇女的筛查,以及分析成本效益高的肿瘤标志物,如嗜银核仁组成区(AgNOR)计数,以区分高危异型增生病例,似乎是对抗宫颈癌的一种合适方法。