title: 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.
abstract: BACKGROUND
  This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India.
  
  
  METHODS
  In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed.
  
  
  RESULTS
  The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of 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 the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.
authors.affiliation: Department of Community Medicine, Chettinad Hospital and Research Institute, Chennai, India. dr.madhutandra.sarkar@gmail.com
authors.forename: Madhutandra
authors.initials: M
authors.lastname: Sarkar
authors.forename: Hiralal
authors.initials: H
authors.lastname: Konar
authors.forename: Deepak
authors.initials: D
authors.lastname: Raut
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011320:Primary Health Care; D011379:Prognosis; D012307:Risk Factors; D063128:Tertiary Health Care