Cervical Screening in Africa Discordant Diagnosis in a Double Independent Reading

Ruche, Guy La; Mensah-Ado, Isabelle; Bergeron, Christine; Welffens-Ekra, Christiane; Dabis, François

doi:10.1016/s0895-4356(99)00081-5

Cited by 10 publications

(8 citation statements)

References 39 publications

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“…A total of 2,198 women attending the clinics were eligible for the study as they fulfilled the following inclusion criteria: age between 20 and 50 years, absence of history of lower genital tract neoplasia, and absence of active pregnancy. The subjects underwent pelvic examination and the obtained cervical smears with Papanicolaou (PAP) method were independently read twice, in Abidjan and in France, in order to minimize false negative/positive results [19]. A colposcopy with biopsies was performed to women with HSIL.…”

Section: Study Populationsmentioning

confidence: 99%

Tobacco smoking and chewing as risk factors for multiple human papillomavirus infections and cervical squamous intraepithelial lesions in two countries (Côte d’Ivoire and Finland) with different tobacco exposure

Simen-Kapeu¹,

Ruche

Kataja

et al. 2008

Cancer Causes Control

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Our objective was to compare the association between tobacco smoking and chewing and the risk of multiple human papillomavirus (HPV) infections and cervical squamous intraepithelial lesions (SILs) in two populations with different tobacco exposure. We studied 2,162 women from Côte d'Ivoire, West Africa, and 419 women from Finland, Northern Europe, with baseline data on cervical screening, HPV DNA status and smoking and chewing habits. The proportion of women who smoked and/or chewed tobacco was higher in Finland (36.8%) than in Côte d'Ivoire (3.7%), where tobacco chewing (2.6%) was more common than tobacco smoking (1.4%). Having multiple HPV infections was common in HPV16 and/or 18-infected women (60.4% in Finland and 47.2% in Côte d'Ivoire). There was no increased risk of multiple HPV infections among tobacco consumers. We found that women >or=30 years of age exposed to tobacco through smoking in Finland (OR: 2.2, 95% CI: 0.5-8.7) and chewing in Côte d'Ivoire (OR: 5.5, 95% CI: 2.1-14) had a moderately or highly increased risk of high-grade SIL, respectively. In the latter, the risk was statistically significant. Our findings emphasize the need for health initiatives targeted to prevent tobacco smoking or chewing among women especially in less industrialized countries.

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Section: Study Populationsmentioning

confidence: 99%

Tobacco smoking and chewing as risk factors for multiple human papillomavirus infections and cervical squamous intraepithelial lesions in two countries (Côte d’Ivoire and Finland) with different tobacco exposure

Simen-Kapeu¹,

Ruche

Kataja

et al. 2008

Cancer Causes Control

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“…The cytology based cervical screening has curbed the incidence of cervical cancer for decades [14]. Previous experiences in many sub-Saharan countries highlighted a lack of reliability of cytology based cervical screening at the population level due to lack of the necessary resources, infrastructure and technological expertise, together with the need for repeated screening at regular intervals [15,16]. …”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Precancerous Cervical Cancer Lesion among HIV-Infected Women in Southern Ethiopia: A Cross-Sectional Study

2013

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IntroductionThe magnitude of precancerous cervical cancer lesions as well as invasive cervical cancer is higher in HIV-infected women than non HIV-infected women. Thus, screening targeting HIV-infected women is being undertaken in developing countries, including Ethiopia. However, data on the prevalence and determinants of precancerous cervical cancer lesion among HIV-infected women in southern Ethiopia is lacking. Thus, this study aimed to assess the prevalence of and factors associated with precancerous cervical cancer lesion among HIV- infected women in southern Ethiopia.MethodsA hospital-based cross-sectional study was conducted from October 2012 to February 2013 among HIV-infected women in Southern Ethiopia. Four hundred forty eight HIV-infected women who had been screened and treated for precancerous cervical cancer lesion were included in the study. Data were collected by using structured and pretested questionnaire. Visual inspection with acetic acid was applied for screening and treatment. SPSS version 16.0 was used for data entry and analysis. Logistic regression analysis was fitted and odds ratios with 95% Confidence intervals and p-values were computed to identify factors associated with precancerous cervical cancer lesion. ResultsOut of 448 study participants, 99 (22.1%) were found to be positive for precancerous cervical cancer. Being currently on highly active antiretroviral treatment (AOR=0.52, 95%CI: 0.35, 0.92), history of sexually transmitted disease (AOR=2.30, 95%CI: 1.23, 4.29) and having only one lifetime sexual partner (AOR=0.33, 95%CI: 0.20, 0.56) were factors associated with precancerous cervical cancer lesion. ConclusionsThe prevalence of precancerous cervical cancer lesion among HIV-infected women in southern Ethiopia was found to be high. Intervention to access all HIV-infected women like scaling up the limited services and awareness creation should be undertaken. Measures aimed at preventing the acquisition and transmission of sexually transmitted diseases and reducing the number of sexual partners are required. Besides, early initiation of highly active antiretroviral treatment is important.

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“…In high-resource countries, cytology-based cervical screening has curbed the incidence of cervical cancer for decades [5]. Due to human resource and infrastructure shortages, previous experiences in Côte d'Ivoire as well as other sub-Saharan countries highlighted a lack of reliability of cytology-based cervical screening at the population level [6,7]. Cervical screening procedures based on the identification of high-risk human papilloma viruses (HPV) have a high capacity to detect precancerous cervical lesions [8,9].…”

Section: Introductionmentioning

confidence: 99%

Cervical cancer screening by visual inspection in Côte d'Ivoire, operational and clinical aspects according to HIV status

et al. 2012

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BackgroundCervical cancer screening is not yet standard of care of women attending HIV care clinics in Africa and presents operational challenges that need to be addressed.MethodsA cervical cancer screening program based on visual inspection methods was conducted in clinics providing antiretroviral treatment (ART) in Abidjan, Côte d'Ivoire. An itinerant team of midwives was in charge of proposing cervical cancer screening to all HIV-positive women enrolled in ART clinics as well as to HIV-negative women who were attending the Abidjan national blood donor clinic. Positively screened women were systematically referred to a colposcopic examination. A phone-based tracking procedure was implemented to reach positively screened women who did not attend the medical consultation. The association between HIV status and cervical cancer screening outcomes was estimated using a multivariate logistic model.ResultsThe frequency of positive visual inspection was 9.0% (95% CI 8.0-10.0) in the 2,998 HIV-positive women and 3.9% (95% CI 2.7-5.1) in the 1,047 HIV-negative ones (p < 10-4). In multivariate analysis, HIV infection was associated with a higher risk of positive visual inspection [OR = 2.28 (95% CI 1.61-3.23)] as well as more extensive lesions involving the endocervical canal [OR = 2.42 (95% CI 1.15-5.08)]. The use of a phone-based tracking procedure enabled a significant reduction of women not attending medical consultation after initial positive screening from 36.5% to 19.8% (p < 10-4).ConclusionThe higher frequency of positive visual inspection among HIV-positive women supports the need to extend cervical cancer screening program to all HIV clinics in West Africa. Women loss to follow-up after being positively screened is a major concern in cervical screening programs but yet, partly amenable to a phone tracking procedure.

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Cervical Screening in Africa Discordant Diagnosis in a Double Independent Reading

Cited by 10 publications

References 39 publications

Tobacco smoking and chewing as risk factors for multiple human papillomavirus infections and cervical squamous intraepithelial lesions in two countries (Côte d’Ivoire and Finland) with different tobacco exposure

Tobacco smoking and chewing as risk factors for multiple human papillomavirus infections and cervical squamous intraepithelial lesions in two countries (Côte d’Ivoire and Finland) with different tobacco exposure

The Prevalence of Precancerous Cervical Cancer Lesion among HIV-Infected Women in Southern Ethiopia: A Cross-Sectional Study

Cervical cancer screening by visual inspection in Côte d'Ivoire, operational and clinical aspects according to HIV status

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