GENITAL TRACT MALIGNANCIES IN POSTMENOPAUSAL WOMEN
Abstract
Background: The most common malignancy in women is breast carcinoma. The next commoncancer is genital tract malignancies which constitute 14% of cancers in women. Objective of thisstudy was to determine the type and frequency of genital tract malignancy in postmenopausalwomen and to find the age distribution of genital tract malignancies. Methods: This descriptivecross sectional study was conducted in Department of Obstetrics ad Gynaecology Unit-II atLiaquat University of Medical and Health Sciences, Jamshoro. All postmenopausal women,admitted in the unit due to various pathologies (abdominal masses, bleeding P/V etc.) fromJanuary 2005 to December 2007 were included in the study. Clinical evaluation and investigationswere done on all patients. Those women who had benign diseases were excluded from the study.Malignancy was confirmed from histopathology report of biopsy specimen. These women weredivided into 3 age groups: group I <60 years, group II 60 to 70 years and group III >70 years.Results: Out of 265 postmenopausal women admitted in ward during the study period,malignancy was confirmed in 68 cases (25.66%). The type of malignancy was cervical carcinoma(41, 60.28%), ovarian carcinoma (11, 16.17%), endometrial carcinoma (8, 11.76%), vulvalcarcinoma (5, 7.35%) vaginal carcinoma (2, 2.94%), and leiomyosarcoma of uterus (1, 1.47%).Increased frequency of cervical and endometrial carcinomas were seen in Group-I cases, whilevulval carcinoma was seen more commonly in Group-II cases (p=0.004). Conclusion: A veryhigh frequency of cervical carcinoma was seen in our patients. There is need for more publicawareness to integrate routine Gynae-Pap screening.Keywords: Postmenopausal, female genital tract, malignancy, frequency, types, women,carcinoma, Pap smearReferences
Panay N. Menopause and the postmenopausal women. In:
Dewhurst’s Textbook of Obstetrics and Gynaecology, 7th
edition. UK: Blackwell publishing; 2007.p. 479–95.
Guy I, Benrubi MD. Pelvic Malignancies. Available from:
www.dcmonline.org/jax_medicine/1999Journals/January99/p
elvicmalig.htm
John C, Weed JR, Clifford S, Marine MD. Seminars in
Surgical Oncology. J Surg Oncol 2006;5(3):176–8.
Ergete W, Tesfaye A. Histopathological finding of post
menopausal bleeding in Ethiopian women. Ethiop J Health
Dev 2001;15(1):39–44.
Shafi MI. Premalignant and malignant disease of cervix. In:
Dewhurst’s Book of Obstetrics and Gynaecology. 7th ed.
Blackwell Publishing; 2007.p. 614–24.
Khan A, Soomro N, Bibi A. Screening for cervical cancer:
Cytology or visual inspection. Med Channel 2001;7(2):1–3.
Blomfield P. Management of cervical cancer. Aust Fam
Physician 2007;36(3)122–5.
Parkin DM, Loara E, Muir CS. Estimates of the world wide
frequency of sixteen major cancers in 1980. Int J Cancer
;41:184–97.
Nugent D, Salha O, Balen AH, Rutherford AJ. Ovarian
neoplasia and subfertility treatments. Br J Obstet Gynaecol
;105:584–501.
Gabra H. Epithelial ovarian cancer. In: Dewhurst’s book of
Obstetrics and Gynaecology. 7th ed. UK; Blackwell
Publishing; 2007.p. 625–35.
Asim SS, Akhtar AZ. Frequency of malignancy in women
presenting with postmenopausal bleeding. Ann Abbasi
Shahid Hosp Karachi Med Dent Coll 2004;9:506–9.
Epstein E, Valentin L. Rebleeding and endometrial growth in
women with postmenopausal bleeding and endometrial
thickness less than 5mm managed by dilatation and curettage
or ultrasound follow up: a randomized controlled study.
Ultrasound Obstet Gynaecol 2001;18:499–504.
Mansour GM, El-lamie IK, El-Kady NA, El-Mekkawi SF,
Laban M, Abou-Gabal AI. Endometrial volume as predictor
of malignancy in women with postmenopausal bleeding. Int.
J Gynaecol Obstet 2007;99(3):206–10.
Naik VS, Rege JD, Jashnani KD. Pathology of genital tract in
postmenopausal bleeding. Bombay Hosp J 2005. Available at:
www.bhj.org/journal/2005_4703_july/html/original_pathology
_250.htm
Luesley DM. Malignant disease of vulva and vagina. In:
Dewhurst’s book of Obstetrics and Gynaecology. 7th ed. UK:
Blackwell Publishing; 2007.p.591–605.
Sugawa T, Hashimoto M, Suzuki M. Clinical aspects and
treatment of vulval cancer in Japan. Asia Oceania J Obstet
Gynaecol 1981;7(2):142–54.
