title: Factors Associated with Delayed Reporting of Invasive Carcinoma Cervix in a Rural Tertiary Care Center.
abstract: BACKGROUND
  The delay in detection of premalignant and malignant lesions can have an adverse impact on the outcome of carcinoma cervix. In spite of relatively good healthcare facilities, women in Kerala continue to report in advanced stages of cervical malignancy.
  
  
  OBJECTIVE
  To analyze factors associated with delayed reporting and to evaluate awareness about screening and vaccination programs for prevention of carcinoma cervix.
  
  
  METHODS
  A cross-sectional study design was used to evaluate the subjects diagnosed to have carcinoma cervix in the outpatient Department of Obstetrics and Gynecology, Government Medical College, Thrissur, Kerala for a period of two years. One-hundred and fifteen women diagnosed to have invasive carcinoma during the study were evaluated. Data analysis was done and expressed as means and percentages.
  
  
  RESULTS
  One-hundred and fifteen women participated in the study. Only 26 (21.7 %) of the subjects were diagnosed in a relatively early stage, i.e., up to stage 2a. Most of them were from families living below poverty line (63.9 %) and were either widowed or divorced (57.3 %). Illiteracy was common (48.9 %) among them, and many (71.3 %) worked as manual laborers. None of the subjects was aware about the availability of screening and vaccination programs for prevention of carcinoma cervix.
  
  
  CONCLUSIONS
  There is a wide gap between the awareness of availability of healthcare and its proper utilization by the poor. Scaling up of public awareness of preventive programs and the availability of healthcare facilities are essential to enable the timely utilization of such services to facilitate early detection of invasive carcinoma cervix.
authors.affiliation: Department of Obstetrics & Gynecology, Government Medical College, Thrissur, Kerala 680596 India.
authors.forename: K R
authors.initials: KR
authors.lastname: Radha
authors.affiliation: Department of Obstetrics & Gynecology, Government Medical College, Thrissur, Kerala 680596 India.
authors.forename: R P
authors.initials: RP
authors.lastname: Reena
keywords: HPV vaccine; Invasive carcinoma cervix; Pap smear; VIA