Histopathological profile of cervical biopsies in northern Malawi: a retrospective cross-sectional study

Abstract

ObjectivesAccording to the WHO (2014), cervical cancer is the second most common cancer in women globally. More than 85% of the global cervical cancer morbidity and mortality occur in low-income and middle-income countries and the highest risk region is in Eastern and Southern Africa. Malawi has the highest age-standardised rate of cervical cancer in the world. This study was carried out to determine the histopathological profile of cervical biopsies in a public tertiary hospital in Mzuzu, northern region of Malawi.SettingA public tertiary hospital in Mzuzu, northern region of Malawi.ParticipantsThis was a retrospective study of all cervical biopsy specimen reports received in a public tertiary hospital in northern Malawi over a period of 5 years from July 2013 to June 2018. Demographic, clinical and diagnostic data were obtained from original histopathology reports.ResultsA total of 500 cervical biopsy reports were reviewed during the study period. The mean age of the patients was 41.99±12.5. Age ranged from 15 to 80 years. Cervicitis accounted for 46.0% (n=162) of the total non-malignant lesions seen, followed by cervical intraepithelial neoplasm, at 24.4% (n=86) and endocervical polyp, at 20.5% (n=72). Squamous cell carcinoma (SCC) accounted for 15.6% (n=78) of the total cervical biopsies studied and 85.7% of all total malignant lesions. Adenocarcinoma and undifferentiated carcinoma were 8.8% and 4.4%, respectively of the total malignant diagnosis. All patients with malignant lesions had HIV.ConclusionOur study shows that cervicitis and SCC were most common among non-malignant and malignant cervical biopsies, respectively. Since the frequency of cervical cancer is high, there is a need to have well detailed national policies to be put in place to increase detection of preinvasive lesions in order to reduce the prevalence of cervical cancer.

Cervical cancer screening among female health workers: Evidence from a secondary health facility in Northern Malawi

“…Therefore, providing health education about cervical cancer prevention to health workers such as hospital facilities might increase their knowledge and awareness of the disease, subsequently increasing the accessibility and practice. This is supported in a study conducted in northern Malawi on Histopathalogical profile of cervical biopsies that also revealed the need to create community awareness and strengthen early cervical cancer screening for Malawi to have better outcomes ( Kaseka, 2022 ).…”

“…Therefore, this study learnt that health workers at KDH lack in-depth understanding of information as they are not frequently updated and this might have been one of contributing factors to inadequate knowledge on risk factors, signs/symptoms and low uptake of screening. This is also alluded to by a study conducted in northern Malawi ( Kaseka, 2022 ) that emphasized the need to have a well organised cervical cancer screening and Pap smear test and programs in Malawi in order to reduce the prevalence of cervical cancer.…”

Clinical profile of geriatric cervical cancer patients in a tertiary hospital in Surabaya, Indonesia

“…Another study by Kaseka et al (2022) showed that squamous cell carcinoma is the most dominant malignant histopathological type in the cervical cancer patient population. 15 The clinical stage classification distribution of geriatric cervical cancer patients in Dr. Soetomo General Academic Hospital, Surabaya in 2020-2021, showed that the majority was IIIB stage as many as 136 cases (77.27%), followed by stage IIB of 28 cases (15.9%) (Table 3). In this study, it was found that the majority of cervical cancer patients at Dr. Soetomo Hospital for the 2020-2021 period was at stage IIIB (77.27%).…”