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Reproductive Tract infections and Premalignant Lesions of Cervix: Evidence from Women Presenting at the Cancer Detection Centre of the Indian Cancer Society, Delhi, 2000–2012

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Abstract

Objectives

Burden of cervical cancer (CC) is highest for women in low- and middle-income countries (LMICs). Human papillomavirus (HPV) is implicated as the necessary cause of CC although a number of other factors aid the long process of CC development. One among them is the presence of reproductive tract infections (RTIs). This study investigated the associations between RTIs and CC from India.

Methods

This study utilized secondary data from the Cancer Detection Centre of the ICS, Delhi. Data were accessed from MS access database and were analyzed using MS Excel and SPSS 16.0. Multivariate analysis using unconditional logistic regression produced odds ratios (ORs) and 95 % confidence intervals (CIs).

Results

This study used data from 11,427 women over a period of 2000–2012. Women with RTIs had Candida, Trichomonas vaginalis (TV) or coccoid infections with all having similar prevalence (~4–5 %). 9.4 % of women had premalignant lesions of cervix; ASCUS was most common (7.9 %) followed by LSIL (1.3 %). TV was significantly associated with ASCUS, LSIL and all premalignant lesions of cervix (P < 0.001). Regression discovered an important association of TV with premalignant lesions of cervix (OR 2.79; 95 % CI 2.14, 3.64).

Conclusions

Earlier studies have depicted associations between TV and HPV with possible enhancement of HPV virulence due to TV. Lack of awareness and hygiene, and limited access to gynecologists in LMICs lead to frequent and persistent RTIs which aid and abet HPV infection and CC occurrence. These also need to be addressed to reduce CC and RTIs among women in LMICs.

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Authors and Affiliations

  1. Indian Institute of Public Health, Delhi, Plot 47, Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India

    Subhojit Dey (Associate Professor) & Arti Mishra

  2. CARE India, Patna, Bihar, India

    Parika Pahwa

  3. Indian Cancer Society, Shahpur Jat, New Delhi, India

    Jyotsna Govil

  4. Centre for Chronic Conditions and Injuries, Plot 47, Sector 44, Gurgaon, Haryana, India

    Preet K. Dhillon

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  1. Subhojit Dey
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  2. Parika Pahwa
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Correspondence to Subhojit Dey.

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None of the authors have any conflicts of interest that might influence this work.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. Exemption from full ethical review for this secondary analysis was obtained from the Public Health Foundation of India (PHFI) Institutional Ethics Committee (IEC) via letter no. TRC-IEC-184/13.

Additional information

Subhojit Dey and Arti Mishra are Associate Professors in Indian Institute of Public Health; Parika Pahwa is a MLE Specialist in CARE India; Jyotsna Govil is a Honorary Secretary in Indian Cancer Society; Preet K. Dhillon is a Senior Scientific Officer in Centre for Chronic Conditions and Injuries.

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Dey, S., Pahwa, P., Mishra, A. et al. Reproductive Tract infections and Premalignant Lesions of Cervix: Evidence from Women Presenting at the Cancer Detection Centre of the Indian Cancer Society, Delhi, 2000–2012. J Obstet Gynecol India 66 (Suppl 1), 441–451 (2016). https://doi.org/10.1007/s13224-015-0819-1

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