Cervical cytology in an urban population in Lagos, Nigeria

Abstract

Eight hundred and eighty-four consecutive women had cervical smears in a clinic in Lagos, Nigeria between September 1998 and 31 August 1999. Mean age was 36.6 - 11.6 years (range 16-81 years); 93.7% were first-time screening. Three hundred and twenty-five (36.5%) smears were normal, inflammatory smears 52.7%, mild dyskaryosis 2.4%, moderate dyskaryosis 1.5%, severe dyskaryosis 0.3% and probable malignancy (malignant cells) 0.8%. Abnormal smears were higher in symptomatic cases compared with asymptomatic cases (chi2=15.3, P< 0.01); 6.1% and 2.1% of symptomatic cases had dyskaryosis and carcinoma, respectively, compared with 3.4% and 0.1% for asymptomatic cases. In postcoital bleeding 9.3% and 1.9% had dyskaryosis and carcinoma, respectively. Fifty-six of 62 cases of cervical erosion had abnormal smears. In postmenopausal bleeding 13.0% and 4.3% had dyskaryosis and carcinoma, respectively. Prevalence of abnormal cervical smears is high in women who have genital tract disease. In places with no national screening programmes every effort should be made to screen such women.

The Association between HIV Infection, Antiretroviral Therapy and Cervical Squamous Intraepithelial Lesions in South Western Nigerian Women

“…Though this prevalence is considerably higher than a range of 5.0–6.8% [23]–[25] reported among HIV negative women in Nigeria, the higher prevalence was used because of the large proportion of HIV positives in this study. The minimum sample size for a statistically meaningful deduction was determined using the formula: N = Zα 2 P (1-P)/d2, where Zα is the Z statistic for a 95% confidence level, N is the sample size, p is the prevalence of cervical cell abnormality, and d is the precision.…”

“…Anorlu et al [23], Durowede et al [24] and Pimentel et al [25] in their separate studies reported lower SIL prevalence of 5.0%, 5.0% and 6.8%, respectively, in Lagos, Okene and Olufadi in Nigeria. The difference between the findings of these studies and our study may be due to the large proportion of HIV positive persons in our cohort.…”

Is colposcopic evaluation necessary in all women with postcoital bleeding?

“…There is no evidence from randomize control trials to answer this question [4,5]. Variations in study design and statistical analysis, study locations (developed or undeveloped countries) are the reasons beyond this dilemma [1,6,7]. Furthermore PCB shows multiple etiologies in which most are benign such as cervicitis or cervical polyps.…”

“…This was consistent in the literature, 60% of naturally menstruating women with PCB will have spontaneous resolution of symptoms within six months. Half of these women will find resolution after two years [7].…”

“…Variations in study design, statistical analysis, and geographical locations (developed or undeveloped countries), are the greatest weaknesses of the published literature [1,6,7]. In another retrospective study of 314 women with PCB, it was found that 20% of women diagnosed with cervical cancer or vaginal cancer on colposcopy had a normal speculum exam with negative cytology prior to the procedure [7]. Therefore we conducted a regression model to answer whether PCB alone is a significant concern, which requires a colposcopy and guided biopsy to diagnose the possibility of CIN2 (+).…”