Liquid-based cytology for the detection of cervical intraepithelial lesions in Jimma town, Ethiopia

Abstract

Background: Cervical cancer is the second leading type of female cancer in Ethiopia. Screening for cervical cancer is primarily conducted using visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) is not yet widely used in Ethiopia. Method: Women aged 21-65 years were tested using LBC and VIA to detect cervical dysplasia. Logistic regression analysis was conducted to identify associated factors. Cohen's Kappa test was conducted to test agreement between LBC and VIA. Results: Forty-two percent (n = 188) of 448 participants were 31 to 40 years of age and only two participants were above 60. Of the 448 participants, 419 (93.5%) were tested with LBC, 294 (65.6%) VIA and 272 (60.7%) with both LBC and VIA. Among women screened using LBC, 305 (72.8%) were negative for intraepithelial lesion or malignancy (NILM), 97 (23.2%) had low-grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) had high-grade squamous intraepithelial lesion (HSIL). Presence of cervical lesions was generally lower in younger and older women. Majority, 39 (40%) of women with LSIL and 10 (59%) with HSIL were 41-50 years of age. Women aged 51-60 were more likely to have abnormal intraepithelial lesions compared to women aged 21-30 (AOR = 20.9, 95% CI = [7.2-60.9], p = 0.00). Out of 47 (10.8%) HIV-positive women, 14 (32.56%) had intraepithelial lesions of which 10 (23.3%) and 4 (9.3%) had LSIL and HSIL, respectively. Among women screened with VIA, 18 (6.1%) were positive; among the 272 (60.7%) women screened using both LBC and VIA, 6 (2.2%) were positive on both LBC and VIA tests. The level of agreement between the two tests was weak at a statistically significant level (kappa value = 0.155, p = 0.006). Conclusion: LBC demonstrated high rates of cervical squamous intra-epithelial lesions in our study. VIA was a less reliable predictor of cervical squamous intra-epithelial lesions than LBC. Evaluating diagnostic accuracy of both LBC and VIA against a histological endpoint should be completed before adopting either or both screening modalities.

[Retracted] Investigation of the Clinical Application Value of HR‐HPV DNA Combined with Liquid Based Cytology in Colposcopy of Cervical Cancer

“…Liquid-based cytology has gradually replaced the traditional Pap smear in specimen collection and specimen preparation technology, and according to some studies, the positive detection rate of liquid-based cytology in squamous epithelial lesions and cervical cancer can reach 93% and 100%, respectively. However, the positive detection rates of traditional Pap smears in the above two cervical lesions are 77.80% and 90.90%, respectively [ 11 , 12 ]. The results of this study showed that the positive rate of liquid-based cytology test results increased with the increase of pathological grade.…”

Histopathological profile of cervical punch biopsies and risk factors associated with high-grade cervical precancerous lesions and cancer in northwest Ethiopia

“…Ameya and his colleague from Hawassa, Ethiopia also reported exactly the same pattern matching our report [ 24 ]. A study in Jimma, Ethiopia also revealed that women above 50 years were more likely to have advanced cervical lesions [ 47 ]. A study in Ghana also revealed that 71% of the patients with cervical cancer were ≥50 years old [ 27 ], which is precisely in line with our report.…”

“…Studies in Ethiopia showed that, patients with cervical cancer were most often visited health facilities after a long time leading to advanced stages of the disease at time of diagnosis [ 47 , 48 ]. This might be due to poor awareness of the disease and the nature of the screening program in the country that is mainly by using VIA technique.…”

Prognostic value of HPV 16/18 genotyping and geminin mRNA quantification in low-grade cervical squamous intraepithelial lesion

“…Cervical cancer is the second most common cancer in women in underdeveloped countries. In 2018, over 300,000 women died from cervical cancer and more than 85% of them occurred in third-world countries [ 19 ]. Screening and treatment of pre-cancer lesions in women beyond 30 years of age is the most cost-effective way to prevent cervical cancer.…”