Screening for cervical cancer: Experience from a university hospital in north western Nigeria (2007-2009)

Abstract

Background: Cervical cancer is the most common gynecological cancer among women in Nigeria. The incidence is on the increase and poses a public health problem. The etiological agent is the human papilloma virus that is sexual transmitted. The cervical cancer incidence is related to lifestyle, poverty and sexual practices. Fortunately, it is a preventable disease as it is preceded by a pre-invasive phase that can be detected and treated. There is paucity of report in literature on cervical cancer screening in Sokoto NorthWest Nigeria. Aim: To determine the uptake, indications and results of cervical cancer screening in Usmanu Dan-fodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: A 3-year descriptive study of the results of cervical cytology among women who attended the gynaecological outpatient clinic of UDUTH, Sokoto. Results: During the period of study, 126 cervical smears were taken and 96% (121/126) of them were considered adequate for cytological evaluation thus constituting the subjects of the study. The average annual uptake of cervical smear was 1.29%. The main indications for cytologic smears were abnormal uterine bleeding 33.9% (41/121) and suspected carcinoma of the cervix 28.1% (34/121). Cytologic study was positive for dysplastic cells in 7% (25/121) of cases. Ten percent (12/121) of them were high grade squamous intra-epithelial lesions while invasive carcinoma was seen in 3.3% (4/121) of the smears. Conclusion: Presence of abnormal cervical smear in 20% of the study subjects underscores the need for routine screening for cervical cancer. While organized national screening policy is awaited, opportunistic screening should be maximized.

Pattern of Cancers Treated with Radiotherapy in Uduth Sokoto: A New Center Experience

“…The Pattern of presentation was disturbing, as most of the patients presented in the late stages of the cancer. Several previous studies have reported late stage presentations [19][20][21][22][23]. Majority of cancer cases were diagnosed at advanced stages probably due to lack of effective screening and early detection services, in addition to the …”

Analysis of Interventions for Improving Cervical-Cancer Screening Uptake among Nigerian Women

“…It causes death of women and weakens the family/community fabric [18]. In Nigeria, cervical-cancer results in about $3.3 million/ Disability Adjusted Life years (DALYS) lost annually in terms of man-hour loss and medical costs [4][5][6][7].…”

“…Though a single visit cervicalcancer screening could save more than 6,000 Nigerian women annually, uptake is low [8]. Out of thirteen different studies on cervical-cancer screening uptake in Nigeria reviewed, nine (69.2%) showed cervical-cancer screening uptake < 5.3%, while four (30.8%) recorded uptake > 5.3% [4][5][6]8,9,[19][20][21][22][23][24][25][26] against 75% with screening rate > 5.0% in developed countries [18].…”

“…Other determinants include; inadequate cues to cervical-cancer screening uptake, low self-efficacy and unavailability, inaccessibility, unaffordability and unacceptability of cervical-cancer screening [6,20,23,26].…”

“…This is unlike developing countries, like Nigeria, where opportunistic cervical-cancer screening, taking advantage of a woman's visit to a health facility is available [3][4][5]. Lack of organized cervical-cancer screening programme and wrong perception of the community towards cervicalcancer screening have led to low uptake of cervical-cancer screening and high cervical-cancer death in Nigeria [6][7][8][9].…”