Incidence of Cervical Intraepithelial Neoplasia in the Outpatient Department: A Study at Islami Bank Medical College Hospital, Rajshahi

Background: Cervical Intraepithelial Neoplasia (CIN) is a precancerous condition and a significant cause of cancer-related mortality among women in developing countries. In Bangladesh, its prevalence is rising due to low screening rates and late-stage diagnosis. Objective: This study aimed to determine the incidence of CIN among women attending the outpatient department of Islami Bank Medical College Hospital, Rajshahi, and to identify associated risk factors. Method: A prospective observational study was conducted in the Department of Obstetrics and Gynecology at Islami Bank Medical College Hospital, Rajshahi, Bangladesh, from January 2020 to December 2023. The study included 218 women aged 30-65 years. Screening for CIN was performed using visual inspection with acetic acid (VIA) and Pap smear/Liquid Based Cytology (LBC). Positive cases were confirmed using colposcopy. Statistical analysis was performed to determine the significance of risk factors, with a p-value <0.05 considered statistically significant. Results: Out of 218 women screened, 35 were diagnosed with CIN, yielding an incidence rate of 16.1% (95% CI: 11.5% - 21.8%). Of these, 20 cases (57.1%) were identified as CIN 1, 10 cases (28.6%) as CIN 2, and 5 cases (14.3%) as CIN 3. The incidence of CIN was significantly associated with early sexual exposure (p=0.03) and multiple sexual partners (p=0.02). The use of VIA and LBC demonstrated a combined sensitivity of 92% for CIN detection. Conclusions: The study highlights a significant incidence of CIN among the outpatient population in IBMC Rajshahi, emphasizing the need for enhanced screening and preventive strategies. Early detection of cervical cancer through VIA and LBC, followed by colposcopy, proves effective in managing CIN. Public health initiatives should focus on increasing awareness, health education, and accessibility to screening services to reduce cervical cancer incidence.