1. AGE DIFFERENCE IN CERVICAL NEOPLASIA DISTRIBUTION AMONG WOMEN ATTENDING A HOSPITAL BASED AND PERIPHERAL SCREENING PROGRAMMES Dr.Kalavathy Mathurchennath1, Saritha.V.N, Sujathan.K, Preethy Sara George 1 Assistant Professor, Regional Cancer Centre, Trivandrum, Kerala, India

2. Background Cervical cancer continues to be the second common malignancy among females of India and Kerala, the rate of which is around 8/100,000/year in Trivandrum Regional Cancer Centre (RCC), Trivandrum, India, runs two parallel cervical cancer screening programmes. One regular pap screening in a tertiary Women & Children Govt hospital, Trivandrum(Group1) and second a peripheral screening programme in different Govt Primary Health Centres (PHC) of Trivandrum (Group2)

3. Objective To see the difference in incidence and age distribution of cervical neoplasia among women attending hospital based and peripheral screening programmes

4. Methodology Hospital based screening programme conducted regularly twice in a week in the Govt Women & Children Hospital, Tycaudu, Trivandrum Women attending the Gynaec OPD are subjected for routine pap Smear examination

5. Methodology …..cont.. Peripheral screening programmes are conducted in 1-2 Govt PHCs in a week. All PHCs in the district are expected to be covered within a period of 18 months. The women for the Pap Smear screening are motivated by the Accredited Social Health Activist (ASHA) female workers.

6. Methodology.. Cont… For both Group1 and Group2, the Pap Smear collection is done by the same team of health staff from RCC. Socio demographic details of each woman subjected for Pap smear is collected as a routine in all the cases.

7. Results Data of a total of 4991 women from Group1 and 3033 from Group2 were analysed.32% of Group1 and.36% of Group2 had Low grade Squamous Intraepithelial Lesions (LSIL) The mean age of incidence of LSIL was 45 in Group1 and 44 in Group2

8. Results..cont.. The incidence of Highgrade Squamous Intraepithelial Lesions (HSIL) was 1.1% in Group1 and.32% in Group2. The mean age of incidence of HSIL was 54.65 in group1 and 43.3 in Group2 and this difference was statistically significant (p value.014)

9. Discussion The almost same LSIL incidence in both groups is expected and the mean age of incidence is also same The hospital group has a higher incidence of HSIL as it expected from a high risk group. The mean age of incidence of HSIL is significantly lower among the peripheral screened population. This has a great public health importance as it helps to detect asymptomatic women with HSIL who have never been to a hospital at an early age and get treated and arrest the development of cervical cancer