Cervical cancer in Indian rural women: Trends over two decades

Worldwide, cervical cancer is considered to be the second commonest cancer as far as mortality and incidence is concerned and India contributes to about 20-30% of the global burden. This paper is based on analysis of records of persons suffering from various cancers over 25 years. Cervical cancer constituted 14.4% of all cancers of men and women put together, 28.8% of the cancers in women and 73.3% of all gynaecological cancer. The cases studied were divided into five Blocks: Block A 1983-1987; Block B 1988-1992; Block C 1993-1997; Block D 1998-2002 and Block E 2003-2007. A 2.34 times increase in cancer cases from Block A to Block E was seen; in women, overall cancer increased by 3.21 times; gynaecological cancer by 3.08 times; cervical cancer 2.91 and ovarian cancer 7.1 times. Cervical cancer in outpatients increased from 0.55% among all gynaecological cases in 1983, to 3.5% in 2007. Cervical cancer comprised of 1.05% of the newly registered outpatients and 70.09% of gynaecological cancer cases. Inpatient gynaecological cancer increased from 2.81% in 1983 to 9.81% in 2007. Out of all cervical cancer in women, cervical cancer was 34.7% in Block A (1983-1987) and 28.6% in Block E (2003-2007). Of the cervical cancer cases, 43.8% belonged to the age group 30-49 years and 37.6% at 50-64 years. Cervical cancer in women with less than three births increased from 13.1% in Block A to 33.1% in Block E. The proportion of illiterate women or those with primary education was seven times more compared with those with secondary education. Our study revealed that cervical cancer still continues to rank first. Also the overall number of cancer cases has been increasing.