ONLINE SUBMISSION
  February, 1998

Pattern of Female Genital Tract Malignancy at a Private Tertiary Hospital

Pages with reference to book, From 51 To 51
  Rubina I. Siddiqui, Sadiqua N. Jafarey  ( Department of Obstetrics and Gynaecology, Ziauddin Medical University, Clifton, Karachi. )
 

Introduction

Cancer of the female genital tract is frequently seen in Pakistan however, the pattern may differ in the public and private sector hospitals. A multi-centre study was conducted by Pakistan Medical Research Council (PMRC) in public sector hospitals in all four provinces of Pakistan which included 2770 women with cancer; of these, 18.5% had gynaecological cancer. Cervical cancer was seen in 245 (8.8%) and ovarian in 174 (6.2%) women1. A study conducted at the Armed Forces Institute of Pathology (AFIP) which caters for anned forces personnel and their families and also receive specimens from other hospitals in Northern Pakistan shows, similar pattern for both cancers. From 1977 to 1988, 12.8% of females seen with cancer had gynaecological malignancy. Ovarian crcer was seen in 4.9 1% and cervical cancer in 4.2% women2.. The purpose of this study was to see the presentation of malignancy of the female genital tract in a private tertiary hospital.


Patients, Methods and Results

A retrospective analysis was performed of all gynaecological operations from 1st January 1992 to 31st December, 1996 at the ZiĆ uddin Medical University Hospital (ZMUH). Total numberof major gynaecological surgeries i.e., all laparotomies, hysterectomies and laparoscopies for this period were recorded from the operating room register The histopathology reports were reviewed and all cases who had any surgery of the genital tract and the report showed malignancy were analyzed in detail. The frequency of gynaecological malignancy in operated cases relative to the total numberof operations was deteunined. Incases of ovarian cancer, the age and parity of the women and stage of disease at presentation was analyzed. During the period of five years, 56 cases of gynaecological malignancies were seen. Forty- six of 754 gynaecological operations done during this period were for malignancy of the female genital tract. The frequency of operations on female genital tract for malignancy therefore 6% (Table I).


Ten cases did not require radical surgery. Chemotherapy was given to two eases of choriocarcinoma and eight eases of late stage cancer of the cervix received radiotherapy. Ovarian cancer was the commonest malignancy of the genital tract in this study. Most of the cases presented in stage III (Table II).

The youngest patient was 9 years old and the peak incidence was at 48-58 years. Forty-eight percent of the patients were grand multipara.


Discussion

This study was conducted ma private tertiary university hospital dealing with a higher social class and ovarian cancer was the predominant genital malignancy. The experience in another private tertiary hospital in Karachi was similar3. In the government hospitals cervical cancer still remains the leading cause of genital cancer1. This probably is a reflection of the lower socio-economic class attending the government hospitals. A higher incidence of cervical cancer is seen in the developing countries like India and Bangladesh as compared to ovarian cance4, whereas, ovarian cancer has higher incidence rates in developed countries and is seen more commonly in upper social classes. Over the past decades however, ovarian cancer has also tended to rise in developing countries and Japan5. At Ziauddin Medical University Hospital 6.1% of the gynaecological operations were for malignancies. Almost half of these were for ovarian malignancy in which debulking was performed. Epidemiological studies in various regions of Pakistan are required to study the pattern of female genital tract malignancies. Thus a true picture of genital cancer in Pakistan will emerge.


References

1. Jafarey, N.A. and Zaidi, S.H.M. Cancer in Pakistan. J. Pak. Med. Assoc,, 1987;37: 1 78-1 83.
2. Ahmed, M., Khan, AN. and Mansoor, A. The pattern of malignant tumours in Northern Pakistan. J. Pak. Med. Assoc., 1991 ;41 :270- 273.
3. Saeed, Ivt, Khalid, K., Iffat, R. et al. A clinico-pathological analyaia of ovarian tumoura. J. Pak. Med. Asaoc., 1991;41 :161- 164.
4. Mis, M.F. Current management and trend of ovarian cancer. The Journal of Obstetrics and Gynaecology, Supplement, Bali, Indonesia, XVth AOFOG Congress, 1995, pp. 15-20.
5. Perkin, 1DM. Cancer occurrence in developing countries. Lyon, IARC Scientific publication No. 75, 1986, p.3.


Pages with reference to book, From 51 To 51

News & Events

Dear Friends and Colleagues,
May you have a very Happy EID with your friends and Family.
May all of us be Blessed with peace and tranquility.
Let us all jointly say a prayer for all troubled persons all over the world
Warm regards,
Dr. Fatema Jawad
Editor-in-chief,
Journal of Pakistan Medical Association, Karachi
President, PAME
Pakistan Association of Medical Editors



WHO/GOARN Request for technical assistance for Cholera Control in Northern Iraq

Request for assistance

WHO is requesting assistance from GOARN partners to identify the following cholera and diarrhoeal diseases expertise to support the Ministry of Health of Iraq in cholera risk assessment and immediate preparedness activities to improve the health outcomes of the Syrian refugees current living in camps in the Kurdistan region of Iraq.

  • two (2) epidemiologists
  • two (2) clinical management experts
  • one (1) environmental health expert (WATSAN)
  • one (1)laboratory expert

Duration

6 day mission starting 13 June 2014 (this excludes travel time).

Location

Northern Iraq (Kurdistan region).

Language requirements

All candidates must be fluent in English- written, spoken and comprehension. Fluency in Arabic is an asset. Knowledge, abilities and skills All candidates are expected to demonstrate the following

  • Ability to conceptualize and promote innovative strategies and policies.
  • Ability to communicate and write in a clear concise manner, and to develop effective guidelines.
  • Excellent negotiation and interpersonal skills complemented by ability to motivate and lead others and to promote consensus. Tact, discretion and diplomacy
  • Demonstrated ability for project appraisal, project management, monitoring and evaluation and project impact assessment.
  • Ability to work with host governments and their agents, INGOs and national NGOs an advantage.
  • Proven experience of managing a large workload and multiple priorities.
  • Ability to work in difficult conditions.

Support to the mission

WHO/GOARN will cover the travel and per diem (to cover daily expense in the field) expenses for the duration of their mission. GOARN missions do NOT offer salary, consultancy fees or any other form of remuneration.

WHO will provide appropriate logistics support for the field mission. Pre-deployment orientation/training may be required at WHO.

Partners offers of assistance

Partners are requested to reply with offers of assistance, together with CVs and details of the availability of staff for this mission by email to goarn@who.int latest by 30 May 2014. Details of all offers from partners and eventual deployments will be maintained on the GOARN SharePoint.

Operational Contacts

Mamunur Malik WHO EMRO malikm@who.int

William Perea WHO HQ pereaw@who.int

Patrick Drury GOARN druryp@who.int



News



Index



Supplement