PREVALENCE OF CERVICAL CANCER, CERVICAL PRE-CANCER AND HPV INFECTION AMONG FEMALE COMMERCIAL SEX WORKERS

Abstract

Female Commercial sex workers (CSWs) represent a high-risk group for human papillomavirus (HPV) infection and cervical abnormalities due to their occupational exposure and limited access to preventive healthcare services. Despite this elevated risk, routine cervical cancer screening and HPV prevention efforts often overlook this vulnerable population. This study aimed to determine the prevalence of cervical cancer, cervical pre-cancerous lesions, and HPV infection among CSWs in a red-light area of Pune, India.

Objective: To determine the prevalence of cervical cancer, cervical pre-cancer, and HPV infection among female commercial sex workers.

Methods: A descriptive, cross-sectional study was conducted among 307 CSWs aged 30–65 years, selected through purposive sampling. Cervical cytological screening was performed using the Papanicolaou (Pap) smear test to detect abnormal cellular changes. Data were analyzed using mean ± standard deviation, frequency, and percentage.

Results: Of the 307 participants screened, 1 individual (0.3%) was diagnosed with confirmed cervical cancer. Pre-cancerous lesions were identified in 29 participants (9%), including 3 cases (0.9%) of high-grade squamous intraepithelial lesion (HSIL) and 26 cases (8%) of low-grade squamous intraepithelial lesion (LSIL). Overall, 214 participants (70%) exhibited abnormal cytological findings, with 172 (56%) classified as high-risk due to multiple coexisting abnormalities such as atypical squamous cells of undetermined significance (ASCUS), cervicitis, and squamous metaplasia. Among a subset of 23 individuals who underwent HPV testing, 26% tested positive for high-risk HPV strains.

Conclusion: This study reveals a notable prevalence of cervical abnormalities and HPV infection among commercial sex workers, emphasizing the urgent need for inclusive cervical cancer screening programs, HPV vaccination, and targeted health education initiatives within this marginalized population.