BackgroundCervical cancer is the leading cause of cancer related death among women in developing countries. Cervical cancer is preceded by cervical surface epithelial cell abnormalities (ECA) which can be detected by Pap smear test. Simultaneous human papillomavirus and human immunodeficiency virus (HIV) infection increases cervical cancer. Data on the prevalence and predictors of ECA among women in Ethiopia is limited. Hence, we aimed to determine the prevalence and associated factors of ECA among women.MethodsA comparative cross-sectional study was conducted among HIV+ and HIV- women attending gynecological examination in cervical cancer screening center at the Debre Markos referral hospital. The study subjects were stratified by HIV status and systematic random sampling method was used to recruit study participants. Cervical smears were collected for Pap smear examination. Logistic regression analysis was employed to examine the possible risk factors of cervical ECA.ResultsA total of 197 HIV+ and 194 HIV- women were enrolled in the study. The overall prevalence of cervical ECA was 14.1 % of which the prevalence of atypical squamous cells undetermined significance (ASCUS), low grade squamous intraepithelial lesion (SIL), high grade SIL, squamous cell carcinoma and ASC, cannot exclude high grade SIL (ASCH) were 5.1, 3.8, 4.1 and 1.0 %, 0.0 % respectively. Significantly higher prevalence of ECA (17.8 %) was observed among HIV+ women (COR 1.9, 95 % CI: 1.1 − 3.4, p = 0.036) as compared to HIV-women (10.3 %). Multiple sexual partnership (AOR 3.2, 95 % CI: 1.1 − 10.0, p = 0.04), early ages of first sexual contact (<15 years) (AOR 5.2, 95 % CI: 1.5 − 17.9, p = 0.009), parity greater than three (AOR 10.9, 95 % CI: 4.2 − 16.8, p < 0.001) and long term oral contraceptive pills (OCP) use (AOR 11.9, 95 % CI: 2.1 − 16.7, p = 0.02) were significant predictors of prevalence of ECA.ConclusionsCervical ECA is a major problem among HIV-infected women. Lower CD4+ T-cell counts of below 350 cells/μl, HIV infection, multiple sexual partnership, early age at first sexual contact, parity greater than three and long term OCP use were significant predictors of prevalence of ECA. Strengthening screening program in HIV+ women should be considered.

Background Cervical cancer is the second most commonly diagnosed cancer among Ethiopian women, killing an estimated 4700 women each year. As the government rolls out the country’s first national cancer control strategy, information on patient and provider experiences in receiving and providing cervical cancer screening, diagnosis, and treatment is critical. Methods This qualitative study aimed to assess the availability of cervical cancer care; explore care barriers and sources of delay; and describe women’s and providers’ perceptions and experiences of care. We analyzed data from 45 informants collected at 16 health centers, district hospitals and referral hospitals in East Gojjam Zone and a support center in Addis Ababa. Thirty providers and ten women receiving care were interviewed, and five women in treatment or post-treatment participated in a focus group discussion. Deductive and inductive codes were used to thematically analyze data. Results Providers lacked equipment and space to screen and treat patients and only 16% had received in-service cervical cancer training. Consequently, few facilities provided screening or preventative treatment. Patients reported low perceptions of risk, high stigma, a lack of knowledge about cervical cancer, and delayed care initiation. All but one patient sought care only when she became symptomatic, and, pre-diagnosis, only half of the patients knew about cervical cancer. Even among those aware of cervical cancer, many assumed they were not at risk because they were not sexually active. Misdiagnosis was another common source of delay experienced by half of the patients. Once diagnosed, women faced multiple-month waits for referrals, and, once in treatment, broken equipment and shortages of hospital beds resulted in additional delays. Barriers to therapeutic treatment included a lack of housing and travel funds. Patient-provider communication of cancer diagnosis was often lacking. Conclusions In-service provider training should be intensified and should include discussions of cervical cancer symptoms. Better distribution of screening and diagnostic supplies to lower-level facilities and better maintenance of treatment equipment at tertiary facilities are also a priority. Expanded cervical cancer health education should focus on stigma reduction and emphasize a broad, wide-spread risk of cervical cancer.

PurposeCervical cancer remains the second most common cancer and cancer-related death among women in Ethiopia. This is the first study, to our knowledge, describing the demographic, and clinicopathologic characteristics of cervical cancer cases in a mainly rural, Southwestern Ethiopian population with a low literacy rate to provide data on the cervical cancer burden and help guide future prevention and intervention efforts.MethodsA descriptive analysis of 154 cervical cancer cases at the Jimma University Teaching Hospital in Southwestern Ethiopia from January 2008 –December 2010 was performed. Demographic and clinical characteristics were obtained from patient questionnaires and cervical punch biopsies were histologically examined.ResultsOf the 154 participants with a histopathologic diagnosis of cervical cancer, 95.36% had not heard of cervical cancer and 89.6% were locally advanced at the time of diagnosis. Moreover, 86.4% of participants were illiterate, and 62% lived in a rural area.ConclusionA majority of the 154 women with cervical cancer studied at the Jimma University Teaching Hospital in Southwestern Ethiopia were illiterate, had not heard of cervical cancer and had advanced disease at the time of diagnosis. Given the low rates of literacy and knowledge regarding cervical cancer in this population which has been shown to correlate with a decreased odds of undergoing screening, future interventions to address the cervical cancer burden here must include an effective educational component.

25Purpose 26 Cervical cancer remains the second most common cancer and cancer-related death among 27 women in Ethiopia. This is the first study, to our knowledge, describing the demographic, and 28 clinicopathologic characteristics of cervical cancer cases in a mainly rural, Southwestern 29 Ethiopian population with a low literacy rate to provide data on the cervical cancer burden and 30 help guide future prevention and intervention efforts. 31 32 Methods 33 A descriptive analysis of 154 cervical cancer cases at the Jimma University Teaching Hospital in 34 Southwestern Ethiopia from January 2008 -December 2010 was performed. Demographic and 35 clinical characteristics were obtained from patient questionnaires and cervical punch biopsies 36 were histologically examined. 37 38 Results 39Of the 154 participants with a histopathologic diagnosis of cervical cancer, 95.36% had not heard 40 of cervical cancer and 89.6% were locally advanced at the time of diagnosis. Moreover, 86.4% 41 of participants were illiterate, and 62% lived in a rural area. 42 43 Conclusion 44 A majority of the 154 women with cervical cancer studied at the Jimma University Teaching 45 Hospital in Southwestern Ethiopia were illiterate, had not heard of cervical cancer and had 46 advanced disease at the time of diagnosis. Given the low rates of literacy and knowledge 3 47 regarding cervical cancer in this population which has been shown to correlate with a decreased 48 odds of undergoing screening, future interventions to address the cervical cancer burden here 49 must include an effective educational component. 50 51 Introduction: 52 Cervical cancer pathology and demographic data is lacking from Southwestern Ethiopia. 53 The Jimma University Teaching Hospital (JUTH) is located in the city of Jimma which is 352 54 km southwest of Ethiopia's capital city Addis Ababa and is unique in that it acts as the only 55 teaching and referral hospital in the region, serving a population of 15 million people [1]. 56 Moreover, Jimma is part of the Oromia state which has one of the highest poverty rates (74.9% 57 of the population) and lowest literacy rates in the country (36% of all residents, with 17% of the 58 female residents living in rural settings) [2-3]. Contributory data from this hospital is vital since 59 every year, an estimated 7,095 women are diagnosed with cervical cancer and 4,732 deaths are 60 due to the disease in Ethiopia -it is currently the second most common cause of female cancer 61 deaths in Ethiopia, after breast cancer. 62 Infection with high-risk human papillomavirus (HPV) is the necessary cause of >99% of 63 cervical cancer [4]. Other contributing factors include smoking, total fertility rate, and human 64 immunodeficiency virus (HIV) infection [5]. The knowledge about cervical cancer in Ethiopia 65has been reported to range from 21.2% to 53.7%, with screening rates that ranged from 9.9% to 66 23.5%. Three of these four studies, however, took place in Northern Ethiopia [6][7][8][9]. Though there 67is not yet an organized cervical cance...

Background: Cervical cancer is the most common cancer among women living in sub-Saharan Africa. Ethiopia has a high incidence of cervical cancer (35.9 per 100,000 women), with 7,095 women diagnosed annually and 4,732 dying every year from the disease. Low provider awareness and poor understanding of appropriate prevention, treatment, and screening interventions pose challenges to addressing this problem. To gauge the extent of this information gap, the study explores variation in healthcare providers' knowledge about HPV and cervical cancer at Debre Markos Referral Hospital, a tertiary public facility located in Ethiopia's Amhara region.