Cervical Intraepithelial Neoplasia in Diabetic Patients: A Cross-Sectional Study in Egypt

  • M. A. Mohammad
  • A. Wageh
  • R. M. Nagib
  • M. E. El-Ghareeb
Original Article



Cervical cancer is the second most common cancer among women. In developing countries, more than 88% deaths from cervical cancer occur. Cancer incidence and mortality are higher among diabetic patients.


To study the presence of cervical intraepithelial neoplasia (CIN) in diabetic patients attending the outpatient clinic of obstetrics and gynecology department in Mansoura University Hospitals using visual inspection with acetic acid test (VIA).

Material and Method

It is a cross-sectional study of 77 diabetic women. VIA test is done in these cases. In positive cases, colposcopic-guided cervical biopsy and histopathological studies are done and the pathological findings are reported. The sensitivity and specificity of VIA are determined.


Out of 77 diabetic cases, 52 were VIA positive. Pathological findings were five cases CIN and three cases cervical cancer. CIN1 was present in 3.89% of cases, CIN2 and CIN3 were present in 2.59% of cases. Cancer cervix was present in 3.89% of cases. VIA test had sensitivity 100% and specificity 38%.


The comparable results of our study to that of general population showed that diabetics are not at risk to develop CIN. VIA test results showed high sensitivity and low specificity.


Cancer cervix VIA CIN DM 



This study was not funded and only used the resources of the university.

Authors’ Contributions

Mohammad MA contributed to collecting data, Wageh A contributed to writing manuscipt, Nagib RM contributed to pathologist and El-Ghareeb ME contributed to general supervision.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Written informed consent was taken from every patient.

Ethical Approval

All procedures performed in our study were in accordance with the ethical standards of our institutional research committee, and our study was approved by ethical committee of Mansoura faculty of medicine.


  1. 1.
    Bhattacharyya AK, Nath JD, Deka H. Comparative study between pap smear and visual inspection with acetic acid (via) in screening of CIN and early cervical cancer. J Midlife Health. 2015;6(2):53–8.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Sciacca L, Vigneri R, Tumminia A, Frasca F, Squatrito S, Frittitta L, Vigneri P. Clinical and molecular mechanisms favoring cancer initiation and progression in diabetic patients. Nutr Metab Cardiovasc Dis. 2013;23(9):808–15.CrossRefPubMedGoogle Scholar
  3. 3.
    Jalil NA, Zin AA, Othman NH. Prevalence of cancers of female organs among patients with diabetes type 2 in Kelantan, Malaysia: observations over an 11 year period and strategies to reduce the incidence. Asian Pac J Cancer Prev. 2015;16(16):7267–70.CrossRefPubMedGoogle Scholar
  4. 4.
    Fuchs O, Sheiner E, Meirovitz M, Davidson E, Sergienko R, Kessous R. The association between a history of gestational diabetes mellitus and future risk for female malignancies. Arch Gynecol Obstet. 2016;. doi: 10.1007/s00404-016-4275-7.PubMedGoogle Scholar
  5. 5.
    Deodhar K, Sankaranarayanan R, Jayant K, Jeronimo J, Thorat R, Hingmire S, Muwonge R, Chiwate A, Deshpande R, Ajit D, Kelkar R, Rekhi B, Ruben I, Malvi SG, Chinoy R, Jambhekar N, Nene BM. Accuracy of concurrent visual and cytology screening in detecting cervical cancer precursors in rural India. Int J Cancer. 2012;131(6):E954–62.CrossRefPubMedGoogle Scholar
  6. 6.
    Gage JC, Ferreccio C, Gonzales M, Arroyo R, Huivin M, Robles SC. Follow-up care of women with an abnormal cytology in a low resource setting. Cancer Detect Prev. 2003;27:466Y71.CrossRefGoogle Scholar
  7. 7.
    Nooh AM, Mohamed MES, El-Alfy Y. Visual inspection of cervix with acetic acid as a screening modality for cervical cancer. J Low Genit Tract Dis. 2015;19(4):340–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Joshi S, Kulkarni V, Darak T, Mahajan U, Srivastava Y, Gupta S, Krishnan S, Mandolkar M, Bharti AC. Cervical cancer screening and treatment of cervical intraepithelial neoplasia in female sex workers using “screen and treat” approach. Int J Womens Health. 2015;4(7):477–83.CrossRefGoogle Scholar
  9. 9.
    Sankaranarayanan R, Nene BM, Dinshaw K, Rajkumar R, Shastri S, Wesley R, Basu P, Sharma R, Thara S, Budukh A, Parkin DM. Early detection of cervical cancer with visual inspection methods: a summary of completed and on-going studies in India. Salud Publ Mex. 2003;45(Suppl 3):S399–407.CrossRefGoogle Scholar
  10. 10.
    Ghaemmaghami F, Behtash N, ModaresGilani M, Mousavi A, Marjani M, Moghimi R. Visual inspection with acetic acid as a feasible screening test for cervical neoplasia in Iran. Int J Gynecol Cancer. 2004;14(3):465–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Sanad AS, Kamel HH, Hasan MM. Prevalence of cervical intraepithelial neoplasia (CIN) in patients attending Minia Maternity University Hospital. Arch Gynecol Obstet. 2014;289(6):1211–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Mroueh AM, Seoud MA, Kaspar HG, Zalloua PA. Prevalence of genital human papillomavirus among Lebanese women. Eur J Gynaecol Oncol. 2002;23:429–32.PubMedGoogle Scholar
  13. 13.
    Vet JN, Kooijman JL, Henderson FC, Aziz FM, Purwoto G, Susanto H, Surya IG, Budiningsih S, Cornain S, Fleuren GJ, Trimbos JB, Peters AA, et al. Single-visit approach of cervical cancer screening: see and treat in Indonesia. Br J Cancer. 2012;107(5):772–7.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Massad LS, Xie X, D’Souza G, Darragh TM, Minkoff H, Wright R, Colie C, Sanchez-Keeland L, Strickler HD. Incidence of cervical precancers among HIV-seropositive women. Am J Obstet Gynecol. 2015;212(5):606.e1-8.CrossRefPubMedGoogle Scholar
  15. 15.
    Kafuruki L, Rambau P, Massinde A, Masalu N. Prevalence and predictors of Cervical Intraepithelial Neoplasia among HIV infected women at Bugando Medical Centre, Mwanza-Tanzania. Infect Agent Cancer. 2013;8(1):45.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Nicolucci A. Epidemiological aspects of neoplasms in diabetes. Acta Diabetol. 2010;47(2):87–95.CrossRefPubMedGoogle Scholar

Copyright information

© Association of Gynecologic Oncologists of India 2017

Authors and Affiliations

  • M. A. Mohammad
    • 1
  • A. Wageh
    • 2
  • R. M. Nagib
    • 3
  • M. E. El-Ghareeb
    • 2
  1. 1.Resident of Obstetrics and GynecologyMinistry of HealthCairoEgypt
  2. 2.Obstetrics and Gynecology Department, Faculty of MedicineMansoura UniversityMansouraEgypt
  3. 3.Pathology Department, Faculty of MedicineMansoura UniversityMansouraEgypt

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