Mane Medical Foundation- CBCC

Home  »  What We Do?  »  CBCC

CBCC

Community based Cervical Cancer Project

 

Synopsis....................................

Awareness, Early detection, appropriate intervention, and adequate follow-up treatment make cervical cancer one of the most preventable of all diseases. The foundation propose a project designed to increase knowledge and awareness of cervical cancer and its prevention and treatment that will ultimately to decrease morbidity and mortality rates for cervical cancer in Rural women’s of  Rehire Tehsil of Ahmednagar  District of Maharashtra State(India). During a3-year project the authors hope to reach about 142473 women’s population and 50000high-risk women who currently do not have access to health care services. The interventions would be based in Rahuri Tehsil of Ahmednagar District of Maharashtra-state specifically in those neighborhoods served by a designated community health center. High rates of cervical cancer are found in Remote villages women usually are overrepresented. About 80 percent of the women served by the designated community health center are either farmer or daily wages worker.

The proposed intervention has three objectives: (a) Increase the use of health services by so-called hard-to-reach women in those communities; (b) to reduce the numbers of women who, after learning of their abnormal Papanicolaou  test results, do not return for follow-up; and (c) to increase sensitivities toward the problem and to encourage participation

In such a project among health care providers at the community health center.

 

EARLY DETECTION, appropriate intervention, and adequate follow-up treatment make cervical cancer one of the most preventable of diseases. Cervical cancer is one of the most common cancers among women worldwide (WHO, 2009b). Its mortality exemplifies health inequity, as its rates are higher in low & middle income countries (LMICs) (WHO, 2009b), and in low socio-economic groups within countries (Kurkure and Yeole, 2006). Around 80% of global cervical cancer cases are in LMICs (Waggoner, 2003)

 

Impact of project –Done on Small Scale basis (Results)

Study setting: Villages of Rahuri Tehsil of Ahmednagar District of Maharashtra.

Study population: All the married women from 12 villages (population of women: 20000) of Rahuri Tehsil.Study period: (month) 2011 to (month) 2015 (five years)

Results:


Table 1: Age wise distribution of the study participants (n=4311)

Sr. No.

Age group (years)

Number of participants (%)

1

≤ 20

500 (11.59%)

2

21 to 30

2050 (47.55%)

3

31 to 40

1073 (24.88%)

4

41 to 50

348 (8.07%)

5

51 to 60

240 (5.56%)

6

≥ 60

100 (2.31%)

Total

 

4311 (100%)

 

 


 

 

Table 2: Distribution of the patients according to Papanicolaou (PAP) test results

 

Papanicolaou test (n =4311)

Test Results (%)

Positive

215 (5.24%)

Negative

4096 (95.01%)

Total

4311 (100%)



Table 3: Distribution of the patients according to Papanicolaou (PAP) grading

 

PAP grading

No of women (%)

Grade I Normal

4096 (95.01%)

Grade II Infectious

120 (2.78%)

Grade III Suspicious

61 (1.41%)

Grade IV Few malignant cell present

19 (0.44%)

Grade V large no. malignant cell present

15 (0.34%)

Total

4311 (100%)

             

Table 4: Distribution of the PAP positive patients according to cervical biopsy test

PAP grading

PAP positive patients for cervical biopsy (n= 95)

Cervical biopsy Positive patients

Grade III

61

40

Grade IV

19

15

Grade V

15

13

Total

95

68

*       

PAP grade I and grade II doesn’t need cervical biopsy



·         Incidence rate of cervical cancer among rural women of Rahuri Tehsil.

 

Incidence =

 

Total number of new case of cervical cancer = 68

Population at risk = 20000

Incidence rate of cervical cancer among rural women was = 3.4 per 1000 per year.


Table 5: Socio-economic class wise distribution of the cervical cancer patients

Socio economic class

Per capita family income for 2011 yr.

Number of cervical cancer patients (%)

Class I

2967 and above

02 (2.94%)

Class II

1483.5 to 2937.33

08 (11.76%)

Class III

890 to 1456.83

09 (13.23%)

Class IV

445.05 to 860.43

18 (26.47%)

Class V

Below 445.05

31 (45.58%)

Total

 

68 (100%)

*        As per modified B.G. Prasad socioeconomic status scale

 


Table 6: Distribution of the cervical cancer patients according to the treatment given

Stage of cervical cancer

No. of patients

Type of treatment given

0

Nil

NA

IA 1

02

Conization or Total abdominal hysterectomy &

B/L Salphingooherectomy

IA 2

05

Radical hysterectomy- Type II

IB 1

06

Radical hysterectomy- Type II

IB 2

09

Radical hysterectomy- Type II

II A

11

Radical hysterectomy or Radiotherapy

II B

14

Radiotherapy

III

09

Radiotherapy

IV A

07

Palliative Radiotherapy

IV B

05

Single chemo or Radiotherapy

Total

68

-

 

 


 

·         Cervical cancer patients survival rate after 5 years after treatment:

 

Survival rate =

 

o   Total number of patients alive after 5 years = 50

o   Total number of patients treated = 68

 

In this study 5 years survival rate of cervical cancer patients is 73.52%.

Discussion:

After comparison above results with national data it has been found that in this project 21.55% women were screened which is higher as compared to national data (2.6%). Cervical cancer survival rate in this project is 73.52% and for national level survival rate is for cervical cancer is46 % compared to the global figure of 50%. Their is 27.52 % increase in cervical cancer survival rate as compared to national level.


The asset of present project and scope on large scale

The current (Small scale) project has addressed the complex factors which have a significant role in the mortality of hard to reach cervical cancer patients. The main focus of our team was to address the critical issues in the early diagnosis and the health care services utilization of underprivileged rural community. The notable assets of this project were outreach services, the walk in clinic, home base PAP screening test and measures to reduce loss to follow up after positive test. The unique feature of this project was the integration of project activities with existing health services to provide comprehensive health care services and for optimum utilization of health services for maximum benefits. Now we wish to spread the wings of a current project to cover all 100 villages of Rahuri Tehsil of Ahmednagar. The villages are home of approximately 142473 hard to reach women. We hope to deliver similar benefits to those women for mitigating their suffering. For this we required monetary blessing which critical for the sustainability of the projects in the future.