Cervical cytology screening in Calcutta and adjoining areas with special reference to carcinoma of the uterine cervix.

Since the incidence of cervical carcinoma in India is high (26% of all cancers in women) health workers routinely conduct cervical screenings. Between 1986-1988 in Calcutta health workers from the West Bengal Cancer Society and Chittaranjan National Cancer Research Centre screened 1232 22-70 year old women (prostitutes and women other than prostitutes) from either slums or adjoining areas for cervical changes using the PAP test. The study did not include any prostitutes in the 51-70 year old age group. The cellular morphology of the cervix of 66.15% of the women was normal. 18.4% had cervical dysplasia and 15.4% had inflammatory cervix. The incidence of dysplasia was much higher in prostitutes (40%) nonprostitutes (16.5%). Pathologists did not find any cases of carcinoma in situ or invasive carcinoma. Incidence and severity of dysplasia increased with age. For example mild dysplasia was highest in 31-50 year old prostitutes and in 61-70 year old women other than prostitutes. Moderate and severe dysplasia did not exist at all in 21-40 year old women other than prostitutes. Further severe dysplasia did not occur until women other than prostitutes reached the 51-60 year old age group. Among prostitutes those in the 31-50 year old age group had the highest incidence of moderate and severe dysplasia. All age groups exhibited an inflammatory cervix except 41-50 year old prostitutes. Cervical dysplasia occurred most frequently among women who married early who gave birth early been married longer and had >1 child. Inflammatory cervix was most common in women who 1st gave birth <25 years old and in women from low socioeconomic groups. The incidence of dysplasia was similar between Hindus and Muslims thereby not supporting the theory that male circumcision protects against cervical changes.