Cervix: Oral Abstract: Nation wide urgent need for colposcopy services: Cancer hospital based study

The cancer cervix is the second most common cancer among women worldwide. About 86% of the cases occur in developing countries and this is responsible for 88% of total deaths. In India 132,000 new cases are diagnosed each year with this disease and 74,000 deaths are recorded annually which accounts for the 1/3^rd of the global deaths from cervical cancer. This hospital based study is designed to look at the distribution of the disease in patients coming to the Mahavir Cancer Sansthan with the aim to achieve an early diagnosis and treatment and recognition of disease in its preinvasive state for better outcome and quality of life. The patient registry data in Mahavir Cancer Sansthan showed that the total number of patients from all cancer were 20,746 in year 2013-2014. The cervical cancer constituted 14% of the patients. 50% of the patients belong to the six district of Bihar which falls in Gangetic plain. 700 case notes have been reviewed for clinical staging at the time of the diagnosis. 71% of the patients were in stage 2b at the time of first clinical presentation, 24% in stage 3% and 4% were in stage 4. Only 1% patients were found in stage1. The colposcopy clinic data suggest only 0.04% patients have approached to us at preinvasive stage. We conclude from this study that although this hospital is mainly a referral cancer hospital 99% patient have reported to the hospital at stage 2b and beyond. Given the natural History of cervical cancer this is only the tip of iceberg. A robust system for colposcopy services needed to diagnose this disease at its preinvasive and micro invasive stage to reduce the morbidity and mortality and improvement in the quality of the life of the patients.