Risk factors for cervical dysplasia in Kerala, India.

ABSTRACT

PIP: In India, cancer of the uterine cervix is the most often seen cancer in women. There are no organized community-based screening programs, mainly because of a lack of resources and a low level of awareness in the population. Findings are presented from a 2-year study in Kerala, India, of the role of genital hygiene and other sexual and reproductive risk factors in cervical dysplasia. 3450 female outpatients of mean age 39.5 years attending the Women and Children's Hospital, Thycaud, Trivandrum, were interviewed, of whom all but 15 were married. 68% of women under age 50 years had been sterilized postpartum, while 2.3%, 0.3%, and 1.8% of women used barrier contraception, oral contraception, and IUDs, respectively. The husbands of 2.3% of the women had undergone vasectomy and no contraception was used by 26% of the women. 33% of the women presented with vaginal discharge, the most common presenting symptom, and lower back pain was experienced by 16%. 70% reported always washing themselves after coitus, but only 8% reported using sanitary pads during menstruation. 93% of women who used sanitary pads had been educated in high schools or colleges. Inflammation was evident in 70% of smears overall; more than 80% of younger women and around 50% of older women. The age-specific prevalences of cytological abnormalities are shown, while regression analysis found increasing age, increasing parity, illiteracy, and poor sexual hygiene to be risk factors for cervical dysplasia. The low level of barrier contraception means that there is little chance of preventing STDs through the use of such methods, and genital tract infection was undoubtedly exacerbated by poor sexual hygiene.