Background: Cervical cancer remains a major public health concern in India despite being largely preventable through screening and human papillomavirus (HPV) vaccination. Delayed diagnosis, poor treatment compliance, and inadequate follow-up continue to compromise treatment outcomes, particularly in resource-limited settings. Clinical audits provide an opportunity to evaluate institutional practices, identify deficiencies in patient care, and guide quality improvement initiatives. Objective: To evaluate the demographic and clinicopathological profile, treatment patterns, treatment compliance, clinical outcomes, treatment-related toxicities, and follow-up status of patients with carcinoma cervix managed at a tertiary care teaching hospital. Materials and Methods: A retrospective clinical audit was conducted in the Department of Radiation Oncology, Sarojini Naidu Medical College, Agra, India. Medical records of 283 consecutive patients with histologically confirmed carcinoma cervix registered between January 2018 and December 2023 were reviewed. Demographic characteristics, FIGO stage, histopathology, treatment details, treatment compliance, response to therapy, treatment-related toxicities, and follow-up data were collected. Of the registered patients, 193 (68.2%) completed the planned treatment protocol and were included for response and toxicity assessment. Data were analysed using descriptive statistics and expressed as frequencies, percentages, medians, and ranges. Results: The median age at presentation was 54 years (range, 18–69 years). Most patients presented with locally advanced disease (FIGO stage III–IV, 59.0%), while squamous cell carcinoma was the predominant histological subtype. Among the 193 patients who completed treatment, the majority received definitive radiotherapy with concurrent platinum-based chemotherapy followed by intracavitary brachytherapy. At the first post-treatment evaluation, 125 patients (65.0%) achieved a complete clinical response, whereas residual disease, progressive disease, and recurrence were observed in 11.0%, 19.0%, and 5.0% of patients, respectively. Anaemia was the most common acute treatment-related toxicity, while bladder and rectal complications represented the predominant late toxicities. Treatment default (31.8%) and poor long-term follow-up were identified as the principal deficiencies in patient management. Conclusion: This clinical audit demonstrates that a substantial proportion of patients continue to present with advanced-stage cervical cancer, reflecting persistent gaps in early detection and timely referral. Although satisfactory clinical response was achieved among patients completing definitive treatment, treatment completion and follow-up remained suboptimal. Strengthening community awareness, expanding cervical cancer screening, improving referral pathways, reducing treatment interruptions, and implementing structured patient-tracking systems are essential quality improvement measures to optimize cervical cancer care in resource-constrained settings.
