Clinico-pathological Features of Gynecological Malignancies in a Tertiary Care Hospital in Eastern India: Importance of Strengthening Primary Health Care in Prevention and Early Detection

Background: This cross-sectional observational study was undertaken to establish clinico-pathologicalcharacteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type andstage of the disease at presentation, in a tertiary care setting in Eastern India. Materials and
Methods: In thegynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptomsof gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundredthirteen patients with histopathologically confirmed gynecological malignancies were interviewed.
Results: Themost frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancieswere excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolongedvaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) hadsquamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly halfof the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes(FIGO) stage III, followed by stage II (40.7%) malignancy.
Conclusions: This study highlights that most of thepatients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer mayoften have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents withsome specific symptoms. These observations point to the need for increasing awareness about gynecologicalmalignancies in the community and providing easily accessible adequate facilities for early detection and treatmentof the disease by optimal use of available resources, i.e. strengthening the primary health care system.