Genital tract malignancies in Trinidad

In Trinidad, genital tract malignancy is the leading cause of death and the commonest of all female cancers, constituting 38.9 per cent of all malignant neoplasms. This clinico-pathological study comprised 82 patients who were diagnosed as having a genital organ malignancy at the Mount Hope Women's Hospital, during a five year period between November, 1981 and October, 1986. The malignancies were categorized by site and broad-type, based on the Sixth International Classification of Diseases. Carcinoma of the cervix was the commonest malignancy (62.2) percent after the age of 25. It was 3.2 times more frequent than corpus uteri cancer, and the mean age at presentation was 54.4 years. Endometrial carcinoma was found only in post-menopausal patients presenting with bleeding at a higher mean age of 63.2 years (0.05>p>.02). Diabetes mellitus, obesity and hypertension were more commonly associated with endometrial carcinoma than with carcinoma of the cervix, but only hypertension significantly so(.01>p>.001). There was no significant difference in the incidence in both major ethnic groups in endometrial and cervical carcinoma. However, only one Muslim patient had a genital tract cancer (p<.05). Forty-four per cent of our patients with Stage I cervical carcinoma were in the reproductive age group (AU)

Gynaecological cancers in Trinidad and Tobago: the case for an oncology service - abstract

Genital tract cancers in Trinidad and Tobago referred to the National Radiotherapy Centre, and all deaths from gynaecological cancers reported by the Government's Central Statistical Office, were included in this study for the period January 1978 to December 1983. There were 587 genital tract cancers and 200 deaths. Cervical cancer was the most common type (67 percent), and the commonest cause of death (70 percent) from gynaecological cancers. This differs from reports in the developed countries where ovarian cancers are the most common, but the age distribution for each site of cancer is the same. No statistically significant difference occurred in the sites of cancer for the two predominant ethnic groups. The need for a comprehensive oncology service was indicated by clinical staging having been done in only one in fifteen cases referred for radiotherapy, and only 8 percent of invasive cervical cancers having had cytological screening before referral for radiotherapy. Further, the Family Planning Association Clinic, in screening 38,501 cervical smears, failed to detect a single invasive cervical cancer, and less than one dyskariotic smear per 1,000 smears. However, a private facility detected one dyskariotic smear per 100, and one occult malignancy per 549 smears. Histological confirmation in 83 percent of genital tract cancers leaves 17 patients at risk of possible unnecessary radiotherapy. A proper oncology service would determine the appropriate therapy, be it radiotherapeutic, surgical, chemotherapeutic, immunological or a combination thereof, for each site and stage of genital tract cancer (AU)

Antibodies to herpes simplex virus (types 1 and 2) in Jamaican patients with cervical dysplasia and neoplasia

Antibody activity to Herpes simplex virus (HSV) types 1 and 2 was measured in sera from women with cervical dysplasia (19 cases), squamous-cell carcinoma, stages 0-4 (54 cases), other genital tumours (15 cases) and matched controls (60 cases) by the indirect immunofluorescent (IFA) test. The frequency of HSV-2 antibody activity was significantly greater in women with cervical cancer than in those with other genital tumours and in matched controls (p<0.05). No significant difference was observed for the HSV-2 antibody activity between women with cervical dysplasia and matched controls. The mean antibody titres to HSV-1 and HSV-2 were significantly higher in cancer cases than the respective titres in control groups (p<0.05). The cervical cancer cases were also analysed according to their clinical stage (Stages 0-4), and there was no significant variation either in frequency of antibody activity, or mean HSV-2 antibody titres. These preliminary findings suggest that there may be an association between HSV-2 and squamous cell carcinoma of uterine cervix in Jamaican women but further studies are required for meaningful conclusions to be drawn (AU)

Endometriosis in Jamaica: report on a 15-year study at the University Hospital of the West Indies (1968-1982)

A clinical and pathological study on 108 cases of endometriosis observed at the University Hospital of the West Indies during a 15-year period (1968-1982) is reported. A low incidence was found when compared with similar studies conducted elsewhere. The peak age at occurence was 36 years. Common clinical manifestations were pelvic pain, infertility, dysmenorrhoea, menorrhagia and dyspareunia. A preoperative diagnosis of endometriosis was made very infrequently. A high index of suspicion, careful clinical examination, including family history, pelvic examinatiuon and laparoscopy are required to improve the accuracy of the clinical diagnosis. The ovaries and the pelvic peritoneum were the commonest sites affected. There was a relatively high frequency of involvement of the fallopian tubes, laparotomy scars, umbilicus, uterine cervix and the vagina (AU)

Choriocarcinoma in Jamaica

Fifty-two cases of choriocarcinoma were recorded in the Jamaica Cancer Registry for the parishes of Kingston and St.Andrew, giving an incidence of 1:7,384 live births. This is intermediate between figures reported for Western metropolitan populations and for Far Eastern countries. Clinicopathological studies on 26 cases treated at the University Hospital in Jamaica revealed that 65 percent followed either normal pregnancy or abortion. Choriocarcinoma following a normal pregnancy or occurring without a previous history of pregnancy carried a poorer prognosis than those with a preceding hydatidiform mole. Many patients had primary neurological manifestations. The overall prognosis was poor due to late presentation with disseminated metastases. Of the 26 patients, 15 died of the disease within two years and only six appeared for a six-year follow-up (AU)