Persistent Challenges in Screening, Late Presentation and the Need to Strengthen National Prevention Efforts in Cervical Cancer in Bangladesh

Open Access

Abstract

Background: Cervical cancer remains a preventable malignancy, yet late presentation continues to challenge cervical cancer control in Bangladesh. Aim of the study: This study aimed to describe prevention-relevant patterns among women with invasive cervical carcinoma managed at tertiary-care centres in Bangladesh. Methods & Materials: This prevention-focused descriptive observational study included 30 women with histologically confirmed invasive carcinoma of the cervix admitted to the oncology units of Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital from January to June 2008. Data were collected using a structured questionnaire and clinical assessment form. Variables relevant to prevention included sociodemographic characteristics, educational status, symptom profile, duration of symptoms before seeking care, clinical stage, histopathology, diagnostic-delay factors, and treatment-delay factors. Data were analyzed descriptively using frequencies and percentages. Results: The mean age was 45 years. Most patients were housewives, 90.00%, and 56.67% belonged to the lower socioeconomic class. Educational attainment was low, with 40.00% illiterate and 33.33% having only primary education. Most patients presented after symptom development; back pain was reported in 73.33%, post-coital bleeding in 63.33%, and foul-smelling per-vaginal discharge in 46.67%. Half of the patients, 50.00%, had symptoms for at least one year before seeking medical advice. Stage II was the most frequent stage, 50.00%, and 80.00% presented with stage II-IV disease. Patient/family-level factors accounted for 70.00% of recorded diagnostic-delay contributors, while system/provider-level factors accounted for 23.33%. False-negative screening was recorded as a cause of delay in 13.33%, and delayed treatment initiation was recorded in 26.67%. Conclusion: The findings indicate persistent prevention gaps reflected by symptomatic diagnosis, prolonged care-seeking delay, and late-stage presentation.