Evaluating Antenatal-Based Cervical Screening as a Strategy to Enhance Cancer Prevention Coverage
DOI:
https://doi.org/10.64149/J.Carcinog.24.7s.28-35Keywords:
Cervical cancer, pregnancy, Pap smear, HPV DNA, antenatal care, screening awarenessAbstract
Background:Cervical cancer remains the second most common malignancy among Indian women and a major cause of morbidity and mortality, despite being largely preventable through screening and HPV vaccination. Pregnancy provides a crucial window for opportunistic cervical screening, as antenatal visits often represent the first contact of women with healthcare systems. This study evaluates the role of antenatal-based cervical screening in enhancing cancer prevention coverage.
Methods:A prospective observational study was conducted among 287 pregnant women attending the antenatal clinic at Government Doon Medical College, Dehradun, over six months. Women aged 18–45 years with a gestational age ≥20 weeks were included. After obtaining informed consent, both Pap smear cytology and HPV DNA testing were performed. Cytological findings were categorized according to the Bethesda 2001 classification, and high-risk HPV genotypes were identified. Sociodemographic variables and associations with abnormal findings were analyzed using SPSS version 26.0, applying the Chi-square test, with p < 0.05 considered significant.
Results:The mean age of participants was 26.5 ± 5.0 years, with most (74.2%) between 21–30 years. Awareness of Pap smear screening was alarmingly low (0.3%) and showed a significant correlation with education level (p = 0.002). Pap smear findings were normal in 82.2% of women, while 16.7% showed inflammatory smears and 1.1% had infection-associated inflammation. HPV DNA positivity was found in 4.2% of participants, with genotype 31 being the most frequent (18.2%), followed by types 6, 11, 16, 18, 33, 45, 52, 66, and 68. Early sexual debut (≤20 years) was significantly associated with abnormal cytology (p = 0.010).
Conclusion:Integrating cervical cancer screening into routine antenatal care can bridge critical gaps in early detection, particularly in low-resource settings. The negligible awareness levels highlight the urgent need for educational interventions and policy measures to embed cervical screening and HPV vaccination within existing maternal health programs.
