Cancer is a major global public health problem and one of the leading causes of morbidity and mortality worldwide. Improvements in life expectancy, urbanization, lifestyle changes, and better control of infectious diseases have contributed to a steady rise in the burden of non-communicable diseases, particularly cancer, in both developed and developing countries.[1,2] According to recent global estimates, approximately 20 million new cancer cases and 9.7 million cancer-related deaths occurred worldwide in 2022, with projections indicating a substantial increase over the coming decades due to population growth and ageing.[3] Among women, breast cancer remains the most frequently diagnosed malignancy globally, followed by lung, colorectal, cervical, and thyroid cancers, while breast cancer continues to be the leading cause of cancer-related mortality among females in many regions.[3,4] In India, cancer has emerged as a significant healthcare challenge, with considerable regional variations in incidence, distribution, and histopathological patterns. Breast cancer is the most common malignancy among Indian women, followed by cervical, ovarian, uterine, and oral cancers.[5] Although organized screening programs and improved awareness have contributed to a decline in cervical cancer incidence in certain urban populations, it remains a major cause of cancer-related morbidity and mortality in rural and underserved areas.[6] Similarly, ovarian cancer continues to have a poor prognosis because most patients present with advanced-stage disease. Understanding the regional distribution and histopathological characteristics of these malignancies is essential for planning effective preventive, diagnostic, and therapeutic strategies. Histopathological examination remains the gold standard for confirming the diagnosis of malignancies and provides critical information regarding tumour type, grade, stage, and prognostic factors that directly influence treatment decisions.[7] Advances in histopathology, including immunohistochemistry, molecular diagnostics, and biomarker analysis, have significantly improved tumour classification, prognostication, and personalized treatment planning.[8] Despite these advances, there is limited region-specific information regarding the histopathological spectrum of female malignancies in central India, particularly in Chhattisgarh. Such data are essential for understanding local disease patterns, identifying demographic variations, and optimizing healthcare resource allocation. The present study was therefore undertaken to evaluate the recent histopathological trends of female malignancies at a tertiary care centre in Raipur, Chhattisgarh, with emphasis on the demographic distribution, histopathological profile, stage at diagnosis, treatment modalities, and clinical outcomes.

Study Design A retrospective observational study was conducted. Study Setting The study was carried out in the Department of Pathology at a tertiary care centre in Raipur, Chhattisgarh, over a period from 2025 to 2026. Study Population The study included 90 female patients with histopathologically confirmed malignancies diagnosed during the study period. Inclusion Criteria • Female patients of any age. • Histopathologically confirmed malignant neoplasms. • Complete medical records containing demographic, clinical, histopathological, treatment, and follow-up information. Exclusion Criteria • Patients with incomplete or missing medical records. • Patients whose histopathological diagnosis was inconclusive. • Patients who received definitive treatment entirely outside the study institution. Sample Size All eligible histopathologically confirmed female malignancy cases available during the study period were included, yielding a final sample size of 90 patients. Data Collection Data were retrieved from hospital medical records and pathology archives using a structured data collection proforma. Information collected included age, presenting complaints, tumour site, histopathological diagnosis, tumour stage, treatment modality, and clinical outcome. Histopathological Evaluation Tissue specimens obtained by biopsy or surgical excision were fixed in 10% neutral buffered formalin, routinely processed, embedded in paraffin, sectioned at 3–5 μm thickness, and stained with hematoxylin and eosin (H&E). Histopathological diagnosis was established by experienced pathologists according to the latest World Health Organization (WHO) classification of tumours. Immunohistochemistry was performed whenever indicated to confirm tumour subtype and establish the final diagnosis. Statistical Analysis Data were entered into Microsoft Excel and analysed using IBM SPSS Statistics version 29.0. Continuous variables were expressed as mean ± standard deviation (SD), whereas categorical variables were presented as frequencies and percentages. Associations between categorical variables were assessed using the Chi-square test or Fisher's exact test, wherever appropriate. Statistical significance was considered at p < 0.05. Survival outcomes were compared according to stage at diagnosis, and statistically significant differences were reported.

The study included 90 female patients diagnosed with malignancies. The mean age of the patients was 50.75±13.55 years), with an age range from 20 to 75 years. The majority of the patients were in the age group of 41-60 years (45.6%). Table 1 presents the detailed demographic distribution. Table 1: Demographic Characteristics Age Group (years) Number of Patients Percentage (%) 20-30 11 12.2 31-40 16 17.8 41-50 23 25.6 51-60 18 20.0 60-70 13 14.4 ≥71 9 10.0 The histopathological analysis revealed a diverse spectrum of malignancies among the study participants. The most common type of malignancy was breast cancer, accounting for 34.4% of the cases, followed by cervical cancer (20%), ovarian cancer (15.6%), endometrial cancer (12.2%), and other types such as gastrointestinal and lung cancers (17.8%). Table 2 details the frequency and percentage of each type of malignancy. Table 2: Distribution of Malignancies Type of Malignancy Number of Patients Percentage (%) Breast Cancer 31 34.4 Cervical Cancer 18 20.0 Ovarian Cancer 14 15.6 Endometrial Cancer 11 12.2 Gastrointestinal Cancer 10 11.1 Lung Cancer 6 6.7 Statistical analysis showed a significant association between the type of malignancy and the age group (p < 0.05). Breast cancer was more prevalent in the 41-50 age group, whereas cervical cancer was more common in the 31-40 age group. Table 3 presents the cross-tabulation of malignancy type by age group. Table 3: Cross-tabulation of malignancy type by age group Age Group (years) Breast Cancer Cervical Cancer Ovarian Cancer Endometrial Cancer Gastrointestinal Cancer Lung Cancer Total 20–30 2 6 1 1 1 0 11 31–40 4 8 3 0 2 0 16 41–50 12 2 4 3 1 0 23 51–60 7 2 3 2 3 2 18 60–70 4 0 2 3 2 2 13 ≥71 2 0 1 2 1 2 9 Total 31 18 14 11 10 6 90 Most of the malignancies were diagnosed at stage II (38.9%) and stage III (28.9%), with fewer cases at stage I (21.1%) and stage IV (11.1%). This distribution highlights the importance of early detection and diagnosis. Table 4 shows the clinical staging of the malignancies. Table 4: Clinical staging of malignancies Clinical Stage Number of Patients Percentage (%) Stage I 19 21.1 Stage II 35 38.9 Stage III 26 28.9 Stage IV 10 11.1 Total 90 100.0 The treatment modalities included surgery, chemotherapy, radiotherapy, and a combination of these. The majority of the patients underwent surgery (47.8%), followed by chemotherapy (28.9%), and radiotherapy (12.2%). Combination therapy was administered to 11.1% of the patients. Table 5 summarizes the treatment modalities. Table 5: Treatment Modalities Treatment Modality Number of Patients Percentage (%) Surgery 43 47.8 Chemotherapy 26 28.9 Radiotherapy 11 12.2 Combination 10 11.1 Total 90 100.0 The survival rate at the end of the study period was 70%, with a higher survival rate observed in patients diagnosed at an earlier stage (Stage I and II) compared to those diagnosed at later stages (Stage III and IV) (p < 0.01).

The present study evaluated the histopathological spectrum of female malignancies at a tertiary care centre in Chhattisgarh and demonstrated that the majority of patients belonged to the 41–60-year age group, with a mean age of 50.75 years. This finding indicates that middle-aged women constitute the most affected population, which is consistent with the natural increase in cancer incidence with advancing age due to cumulative genetic alterations, prolonged exposure to environmental risk factors, and hormonal influences. Similar age distributions have been reported in several Indian studies, emphasizing the importance of targeted screening and awareness programs for women in this age group.[10–13] Breast cancer was the most common malignancy (34.4%) in the present study, followed by cervical cancer (20.0%), ovarian cancer (15.5%), and endometrial cancer (12.2%). These findings are in agreement with the current epidemiological profile of female cancers in India, where breast cancer has surpassed cervical cancer as the leading malignancy among women. The predominance of breast cancer may be attributed to changing reproductive patterns, delayed childbearing, obesity, sedentary lifestyle, and improved diagnostic facilities. Cervical cancer remains the second most common malignancy, reflecting persistent gaps in organized screening, HPV vaccination, and access to preventive healthcare, particularly in underserved populations. The observed significant association between age group and type of malignancy (p < 0.05) further suggests that age-specific screening strategies may improve early diagnosis and disease management. Most patients in the present study were diagnosed at Stage II (38.9%) or Stage III (28.9%), while only 21.1% were diagnosed at Stage I. Although this distribution indicates that a proportion of patients are being identified before advanced disease develops, a considerable number continue to present with locally advanced malignancies. Delayed presentation may result from limited awareness, socioeconomic barriers, inadequate screening facilities, fear of diagnosis, and restricted access to specialized oncology services. The significantly better survival observed among patients diagnosed at earlier stages (p < 0.01) highlights the critical importance of early detection, timely referral, and prompt initiation of treatment. These findings are consistent with established evidence that stage at diagnosis remains one of the strongest predictors of survival across most female malignancies. Surgery was the most frequently employed treatment modality (47.8%), followed by chemotherapy (28.9%), radiotherapy (12.2%), and combination therapy (11.1%). This treatment pattern reflects contemporary oncological practice, where surgery remains the cornerstone of management for localized solid tumours, particularly breast, ovarian, and endometrial cancers. Multimodal treatment approaches incorporating chemotherapy and radiotherapy were utilized according to tumour type and stage, emphasizing the need for comprehensive multidisciplinary cancer care. The overall survival rate of 70% observed in the present study further supports the effectiveness of timely diagnosis and appropriate treatment, although longer follow-up is required to determine long-term disease-free and overall survival. The findings of the present study are comparable with those reported by Patil et al.[10], who evaluated the histopathological spectrum of female malignancies in Western Maharashtra and observed that most patients were between 40 and 69 years of age. Breast cancer was the commonest malignancy, followed by cervical and ovarian cancers, with infiltrating ductal carcinoma being the predominant histological subtype of breast cancer and squamous cell carcinoma the commonest cervical malignancy. Their observations closely parallel the age distribution and cancer pattern observed in the present study. Similarly, Singh et al.[11] reported that among 724 neoplastic lesions, 225 were malignant, with breast malignancies representing one of the leading cancer types in women. They emphasized the indispensable role of histopathological examination in establishing definitive diagnosis and guiding clinical management. Although oral cavity malignancies were more frequent in their overall study population, the importance of tissue diagnosis highlighted by their study supports the present findings. Kumar et al.[12] evaluated malignant lesions diagnosed at a tertiary care centre and found a slightly higher prevalence of malignancies among female patients, with cervical and breast cancers constituting the majority of female cancers. Their study emphasized the importance of preventive strategies, public awareness, and risk-factor modification, findings that are in agreement with the present study, which advocates strengthening cancer screening and early detection initiatives. Likewise, Sharma et al.[13] analyzed the histopathological spectrum of breast lesions and reported invasive ductal carcinoma as the predominant malignant subtype, while benign lesions accounted for the majority of breast specimens. Their study reinforced the value of early diagnosis and timely intervention in reducing morbidity and mortality associated with breast cancer, consistent with the improved survival observed among patients diagnosed at earlier stages in the present study. Overall, the present study provides important regional data on the histopathological spectrum of female malignancies in Chhattisgarh. The predominance of breast and cervical cancers, the significant association between age and tumour type, and the improved survival among early-stage cases collectively emphasize the urgent need to strengthen organized screening programs, promote awareness regarding early symptoms, expand access to histopathological diagnostic services, and develop comprehensive multidisciplinary oncology care to improve outcomes among women in this region.

The present study demonstrated that breast cancer is the most common female malignancy in Chhattisgarh, followed by cervical and ovarian cancers, with the majority of patients presenting in the fifth and sixth decades of life. Most malignancies were diagnosed at Stage II or Stage III, indicating the need for earlier diagnosis through effective screening and awareness programs. Histopathological examination remains indispensable for accurate diagnosis, tumour classification, and treatment planning. Early-stage diagnosis was associated with significantly better survival, highlighting the critical role of timely detection and appropriate management. Strengthening population-based screening, improving access to diagnostic facilities, promoting HPV vaccination and breast cancer awareness, and expanding multidisciplinary oncology services are essential to reduce the burden of female malignancies and improve long-term patient outcomes in Chhattisgarh.

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