Observed and Expected Incidence of Cervical Cancer in Lusaka and the Southern and Western Provinces of Zambia, 2007 to 2012

Abstract

Objectives Cervical cancer is increasing but underestimated in developing countries. We calculated the observed and expected incidence of cervical cancer in Lusaka and Southern and Western provinces of Zambia. Methods/Materials Data for 2007-2012 was obtained for the 3 provinces. Data included age, residence, year of diagnosis, marital status, occupation, HIV, stage, radiotherapy and chemotherapy. Expected incidence in Southern and Western provinces was calculated based on observed incidence for Lusaka province, adjusting for HIV. Results Crude and age-standardized incidence rates (ASR) in Lusaka were 2-4 times higher than incidence in the other 2 provinces. Lusaka had a rate of 54.1/105 and ASR of 82.1/105 in the age group 15-49. The Southern province had a rate of 17.1/105 and ASR of 25.5/105; Western province rate of 12.3/105 and ASR rate of 17.2/105. The observed cervical cancer incidence rates in the Southern and Western provinces were lower than the rate in Lusaka, possibly due to the uncertainty of underreporting/under-diagnosis or actual lower risk for reasons yet unclear. HIV seroprevalence rate in patients from the 3 provinces were 46 – 93% higher than seroprevalence in the respective general populations. Conclusion Cervical cancer is significantly underestimated in Zambia and HIV has a significant role in pathogenesis. Future studies should establish methods for case ascertainment and better utilization of hospital- and population-based registries in Zambia and other similar developing countries.

Effects of HIV status on non-metastatic cervical cancer progression among patients in Lusaka, Zambia

“…Cervical cancer is the fourth most common malignancy among women worldwide, with the highest incidence and mortality occurring in Sub-Saharan Africa 1. This is a major public health challenge in Zambia, where the cervical cancer annual incidence rate is estimated to be between 33.7 and 58.4 per 100 000 with a mortality rate between 20.7 and 36.2 per 100,000 2–4. While the primary cause for cervical cancer is human papillomavirus (HPV), co-infection with HIV appears to increase the likelihood of progression to cancer 5.…”

“…Women with HIV who are exposed to HPV are less likely to clear the virus and more likely to develop cervical cancer 6. Zambia has a national adult HIV prevalence of 16%, with an estimated 20.8% prevalence for women 15–49 2. Furthermore, the prevalence of high-risk HPV oncogenic types 16 and 18 each is 21.6% in Zambia 7…”

“…The Cancer Diseases Hospital is a specialized hospital for cancer treatment that opened in Lusaka, Zambia in late 2006 and now provides radiotherapy and chemotherapy to cancer patients 2. Due to the national lack of screening and early detection services they report a large number of advanced stage III and IV cervical cancer 8.…”

The protective role of DMBT1 in cervical squamous cell carcinoma

“…As estimated, approximately 485 000 patients were newly diagnosed, with nearly 236 000 die from cervical cancer worldwide in 2013, among which 85% cases were from developing countries . At present, its morbidity is still rising gradually in developing countries . As shown by cancer statistics in China (2015), the incidence rate of cervical cancer in China ranks second globally .…”

Community groups to increase Human papillomavirus (HPV) vaccination through Participatory Learning and Action, Reducing barriers and increasing community Mobilisation in Zambia (CHARMZ) project.

“…Participants will be purposively sampled from communities in the district Chongwe in Lusaka province, as Lusaka has the highest incidence of cervical cancer compared to other provinces in Zambia (36) and most research on HPV vaccination hesitancy in Zambia has been conducted there (13,14,37). Furthermore, Chongwe was chosen for its rural setting, where community groups have been shown to be most effective (23).…”