IMPLICATIONS OF GYNECOLOGICAL ABNORMALITIES IN PRESELECTION CRITERIA FOR CERVICAL SCREENING - PRELIMINARY EVALUATION OF 3602 SUBJECTS IN SOUTH-INDIA

Early detection and eradication of cervical cancer and its precursor l esions through organized mass cytological screening programmes have re cently gained considerable attention in developing countries. Strategi es for both cost saving and effective implementation are however requi red for mass cervical screening in developing countries. In an early c ancer detection programme conducted in South India, we analysed cytolo gical abnormalities in 3602 women and correlated the results with othe r factors, including age, gynaecological complaints, number of years o f married life and parity to see if pre-selection for cytologic screen ing was possible. Only lower grades of dysplasia were found in asympto matic women below the age of 40 years. In asymptomatic women, malignan cy and higher grades of dysplasia were confined to women with a clinic ally abnormal cervix only. Univariate analysis also revealed that subj ects with a parity of more than 3 and a married life of more than 20 y ears had a significantly higher number of cytological abnormalities. H owever, on a multivariate analysis the increased number of marital yea rs was not found to be an independent variable. These results suggest that asymptomatic women below the age of 40 years with a married life of less than 20 years and parity below 3, may be excluded from screeni ng campaigns, and that pre-selection for cytologic screening is possib le by introducing a programme of clinical and speculum examination of the cervix.