CLINICO – PATHOLOGIC STUDY OF CERVICAL MALIGNANCY AT CALABAR (A TEN YEAR RETROSPECTIVE STUDY)

Abstract

Cervical cancer is one of the most common neoplastic diseases affecting
women, with a combined worldwide incidence of almost half a million new
cases annually, second only to breast cancer. Basic and epidemiologic research
conducted during the past 15-20 years have provided overwhelming evidence
for an etiologic role for infection with certain types of sexually-transmitted
human papillomavirus (HPV) as the primary cause of cervical cancer. The
relative risks of cervical cancer following HPV infection as ascertained in case
control and cohort studies are among the highest in cancer epidemiology. The
available evidence indicates that the HPV-cervical cancer association satisfies
all relevant causal criteria for public health action. Other cervical cancer risk
factors, such as smoking, parity, use of oral contraceptives, diet, other
infections, and host susceptibility traits must be understood in the context of
mediation of acquisition of HPV infection or in influencing events of the natural
history of cervical neoplasia that occur following the establishment of a
persistent HPV infection. Virtually all cervical carcinoma specimens contain
HPV DNA, which suggests that HPV infection is a necessary cause of cervical
neoplasia.

There were 1207 malignancies diagnosed during the study period; 175 (14.5%)
were malignancies of the genital tract while 113 (9.4.0%) were carcinoma of the
cervix constituting 64.6% of female genital malignancies. Cervical cancer was
commonest between the ages of 40-59 years. There was no patient with
carcinoma of the cervix below the age of 20 years. Abnormal vaginal bleeding
(90.5%) in pre and post-menopausal periods was the commonest presenting
complaint while squamous cell carcinoma (87.6%) of the uterine cervix was the
main histological type.