PATTERN OF GYNAECOLOGICAL MALIGNANCIES IN DELTA STATE UNIVERSITY TEACHING HOSPITAL,OGHARA:A 2 YEAR REVIEW. MOFON C EBEIGBE P.E ABEDI H.O DELSUTH.

OUTLINE INTRODUCTION OBJECTIVE MATERIALS AND METHOD RESULTS CONCLUSION RECOMMENDATION REFERENCES

INTRODUCTION Malignancies of the female genital tract are a major public health issue globally and contributes significantly to cancer related morbidity and mortality worldwide. The burden of gynaecological cancers in developing countries appears huge.1 In these countries, gynaecological cancers account for 25% of all new cancers diagnosed among women aged up to 65 years compared to 16% in the developed world.1

The pattern and prevalence of genital tract malignancies show wide geographic variations with several studies reporting varying patterns of prevalence and presentation between developing and developed countries.2,3 Within the same country, there are also differences in prevalence and pattern between urban and rural areas.2,3 Determination of pattern of gynaecological malignancies will help in setting priorities for disease prevention and control.

OBJECTIVE To determine the incidence and clinical pattern of presentation of gynaecological malignancies in DELSUTH, Oghara.

MATERIALS AND METHODS This was a descriptive study of all gynaecological malignancies whether diagnosed clinically, radiologically or surgically but confirmed by histopathology at DELSUTH from November 1 2010 to October 30, 2012. Ethical approval was obtained from the Hospital Health and Research ethical committee. Data was analyzed using SPSS 19 and results was displayed on tables and compared with available reports of similar studies from other centers.

RESULTS During the period, there were 109 patients with gynaecological malignancies which accounted for 3% of 3774 patients seen at gynaecology clinics and 21% of 494 patients admitted to the gynaecology wards. Cervical cancer was the most common gynaecological malignancy accounting for 70.30%. 13.86% had ovarian cancer, 12.87% had endometrial cancer and 2.97% had vulvar cancer respectively. There were no cases of vagina or fallopian tube cancers

The age range of the patients that had gynaecological malignancies was between 29 – 84 years with a mean age for all gynaecological malignancies of 52.37 ± 13.1years. The mean parity for patients with gynaecological cancer was Para 6. 63% of patients with cervical cancer were Para 5 and above. 46% of patients with ovarian cancer were nulliparous and this constituted the majority.

The most common presenting complaint in patients with cervical cancer was post coital bleeding and offensive vaginal discharge. 57.1% of patients with ovarian cancer presented with abdominal swelling and abdominal pain making it the commonest presenting complaint. 76.9% patients with endometrial cancer presented with Post-menopausal bleeding, abnormal vaginal discharge and abdominal pain as their main presenting complain respectively. All the patients with vulva cancer presented with vulva ulceration.

Most of the patients with cervical cancer presented with advanced disease.60.6% and 19.7% presented with stage III and IV and disease. 50% of patients with ovarian cancer presented with stage IV ovarian cancer. 46.2% patients with endometrial cancer presented with at Stage II and III of the disease. 75% of patients with vulva cancer presented with stage II disease.

CONCLUSION Cervical cancer is the most common gynaecological cancer seen in DELSUTH with most patients presenting with advanced disease. Reduction of morbidity and mortality from gynaecological cancer first involves tackling cervical cancer

RECOMMENDATIONS Education of the public especially females on the risk factors and early symptoms of cervical cancer. Establishment of dedicated and workable National cervical cancer screening programs. Strengthening of gynaecologic oncology services by better training of manpower and provision of facilities for treatment.

References 1. Iyoke C, Ugwu G. Burden of Gynaecological cancers in developing countries. World Journal of Obstetrics and Gynaecology. 2013;2(1): 1- 7. 2. Jamal S, Mamoon N, Mushtaq S, Luqman M, Moghal S. The pattern of gynaecological emergencies in 968 cases from Pakistan. Ann Saudi Med 2006; 26 (5): 382-384 3.Dey S, Hablas A, Seifeldin I, Soliman A. Urban – rural differences of gynaecological malignancies in Egypt (1999-2002).Br J Obstet Gynaecol; 117 (3):348-355.

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