<p>Predictors of Precancerous Cervical Lesions Among Women Screened for Cervical Cancer in Bahir Dar Town, Ethiopia: A Case–Control Study</p>

Abstract

Purpose Cancer of the cervix is the second most common cancer among women worldwide. Despite it is a serious public health problem in Sub-Saharan African countries including Ethiopia, formation on predictor of the precancerous cervical lesion is not well documented, particularly in the study area. This study aimed to identify the predictors of precancerous cervical lesions among women screened for cervical cancer in Bahir Dar town, North West Ethiopia, 2018/19. Patient and Methods Institution-based unmatched case–control study was conducted in selected health facilities in Bahir Dar town from November 15, 2018, to January 16, 2019. Data were collected from 102 cases and 305 controls using an interviewer-administered structured questionnaire and entered into Epi Data version 3.1, then export to SPSS version 23 for analysis. Variables with P-value ≤0.2 in the bivariate analysis were included in the multivariate logistic regression model. Odds ratio with 95% confidence interval was used to identify the predictors of precancerous cervical lesions. Results Women who initiated sexual intercourse before the age of 18 years (AOR = 1.68, 95% CI: 1.015–2.804), history of sexually transmitted infection (AOR =1.74, 95% CI: 1.087–2.790) and two or more lifetime sexual partners (AOR=1.733, 95% CI: 1.069–2.810) were predictors for a precancerous cervical lesions. Conclusion This study confirms that the initiation of sexual intercourse before the age of 18 years, having history of sexually transmitted infection, and two or more lifetime sexual partners were determinants for precancerous cervical lesions. So that it should be focused on prevention through early detection and treatment of sexually transmitted infection with condom promotion. Women with a higher risk of precancerous lesions should also be encouraged to be screened more frequently for cervical cancer.

Determinants of precancerous cervical lesion among HIV infected women on ART in Woldia comprehensive specialized hospital NorthEast Ethiopia

“…The finding was comparable with a study conducted in Southern Ethiopia, Gahandi Memorial Hospital, and Addis Ababa that multiple sexual partners were a determinant factor for the development of precancerous cervical lesions [ 29 , 35 , 36 ]. And also, have been comparable with the study conducted in three referral Hospitals in Amhara Region, Bahrdar Town, and Gondar University Comprehensive Specialized Hospital [ 12 , 37 , 38 ]. This could be because women who have had 2 or more lifetime sexual partners are more likely to develop precancerous cervical lesions, as the number of sexual partners increases; they are more likely to contract the HPV infection, which is the cause of cervical cancer and invasive cervical cancer.…”

“…The study found that women who initiated sexual intercourse before 18 years were more likely to develop pre-cancerous cervical lesions than women who started sexual intercourse after 18 years. The finding of this study was consistent with studies done in North shoa and Mari stope Ethiopia in Adama in which women who had a history of early initiation of first sexual intercourse before 15 were at higher risk to develop precancerous cervical lesion than those whose age is greater than 15 years age [ 24 , 41 ].and also this study similar with the study conducted in Bahrdar Town And Gahandi Memorial Hospital early initiation of first sexual intercourse before the age of 18 were risk of developing precancerous cervical lesions compare with after the age 18 [ 36 , 37 ]. This might be because at this age cervical tissue undergoes physiologic changes, the transformation zone on the ectocervix is enlarged, and exposure to HPV at such times may facilitate infection which may make this area more vulnerable to the development of dysplasia, a cervical squamous cancer.…”

Prevalence of human papillomavirus infection and associated factors among women attending cervical cancer screening in setting of Addis Ababa, Ethiopia

“…Among HPV positive individuals, half of them started sexual intercourse at 12–17 years of age. Similarly, in a study in Bahir Dar Town, women who had initiated sexual intercourse at the age of 18 were 1.7 times more likely to have the lesion compared to those who initiated sexual intercourse at the age of 18 years and later 30 . Starting sexual intercourse at an earlier age increases the risk of HPV and cervical cancer, as reported in several previous studies 14 , 30 , 31 .…”

“…Similarly, in a study in Bahir Dar Town, women who had initiated sexual intercourse at the age of 18 were 1.7 times more likely to have the lesion compared to those who initiated sexual intercourse at the age of 18 years and later 30 . Starting sexual intercourse at an earlier age increases the risk of HPV and cervical cancer, as reported in several previous studies 14 , 30 , 31 . Having started sexual intercourse at an earlier age leads women to give birth before the age of 18 years.…”

The association between HIV infection and precancerous cervical lesion. A systematic review and meta‐analysis of case–control studies

“…Two studies used record review (secondary data) to collect the necessary information. 17 , 26 Regarding the study area: four studies were from the Amhara region, 19 , 27 , 28 , 29 three studies were from the Oromia region, 16 , 17 , 30 two studies were from the Southern Nations Nationalities and Peoples region, 26 , 31 and one study was from Addis Ababa. 11 Moreover, only three studies reported a significant association between HIV infection and precancerous cervical lesion; yet the adjusted odds ratio ranges from 3.41 to 7.41 26 , 27 , 30 (Table 1 ).…”