scholarly journals A Decade of Cervical Cancer Screening: Trends of Incidence in Zambia (2007-2017)

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 33s-33s ◽  
Author(s):  
J. Matambo ◽  
A. Manasyan ◽  
S. Kapambwe

Background: Cervical cancer is a highly preventable disease and the major cause of cancer related illness and deaths in Africa. Cervical cancer screening to find precancers before becoming invasive cancer is a well-proven way to prevent cervical cancer. In Zambia alone, over 2000 cervical cancer cases are diagnosed each year accounting for over 30% of new cancer cases with a mortality of above 35%. Women access screening services regardless of HIV status as long as they are sexually active. Cervical cancer screening for HIV-positive women in Zambia remains low despite the high burden of the disease among this population. Aim: We aimed to determine the trends of incidence of cervical precancer lesions among women who ever presented for screening in Lusaka. Methods: We conducted a retrospective cohort study of 95,520 women who presented for cervical cancer screening between 2007 and 2017 at 11 Lusaka district clinics that provide cervical cancer screening. Data were merged from these clinics and cleaned. Descriptive analyses and Logistic regression for data analysis was conducted. Results: The study showed that the mean age of screening among women that were HIV negative and HIV-positive was 34 years. About 12% of the women that screened had a positive VIA result from which 59% were HIV-positive. Results also showed the odds of 4 to be VIA positive when one is HIV-positive. Conclusion: We have data to show that there is an increased risk among HIV-positive women to be VIA positive in Zambia. HIV infected women should be targeted as priority for cervical cancer screening especially in the resource limited countries. Resources directed to HIV care programs in these settings should be leveraged and include cervical cancer screening.

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255124
Author(s):  
Kathryn L. Hopkins ◽  
Maya Jaffer ◽  
Khuthadzo E. Hlongwane ◽  
Kennedy Otwombe ◽  
Janan Dietrich ◽  
...  

Objective A screening centre in Soweto, South Africa (SA), investigated high-risk human papillomavirus (HR-HPV), HIV, cervical cancer risk amongst women. Methods This cross-sectional study (June 2018-March 2019) describes screening results (Roche Linear Array HPV test and Pap smear liquid based cytology) and history of screening (known HIV status, antiretroviral therapy [ART] use, previous Pap smears). Data were stratified by age group (18–29, 30+ years), HIV status, Pap smear results and tested for statistical significance. Results Of 280 women, 20.4% were HIV-positive, 18.2% had abnormal Pap smears, 41.8% had HR-HPV. Of older women, 48.2% (n = 78/162) had never had a Pap smear. Of younger women, 89.0% (n = 105/118) never had a Pap smear, but had significantly more low-grade squamous intraepithelial lesions (LSIL) and other HR-HPV infection than older women (12.7%[n = 15/118] vs 4.9%[n = 8/162], p = 0.0193; and 49.2%[n = 58/118] vs 29.0%[n = 47/162], p = 0.0006; respectively). HIV-positive women had more abnormal cytology results and infection with other HR-HPV types or co-infection with other HR-HPV type(s)/HPV-16 compared to HIV-negative women (35.1%[n = 20/57] vs 13.9%[n = 31/223], p = 0.0002; 56.1%[n = 32/57] vs 32.7%[n = 73/223], p = 0.001; and 12.3%[n = 7/57] vs 4.9%[n = 11/223], p = 0.044; respectively). Of 57 HIV-positive women, 45.6% (n = 26) already knew their HIV status; of which 69.2% were on ART and 34.6% never had a Pap smear. Conclusion South African women have high rates of HIV, Pap smear abnormalities and HR-HPV, with low cervical cancer screening coverage. SA cervical cancer screening policy excludes (undiagnosed) HIV-positive and HIV-negative women <30 years, both populations found to have high prevalence of HR-HPV. HPV-based primary screening from 25 years could improve outcomes.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Abiyu Ayalew Assefa ◽  
Feleke Hailemichael Astawesegn ◽  
Bethlehem Eshetu

Abstract Background In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. Methods An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05. Results Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization. Conclusions The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.


2006 ◽  
Vol 15 (6) ◽  
pp. 554-556 ◽  
Author(s):  
Silvia Franceschi ◽  
Luigino Dal Maso ◽  
Barbara Suligoi ◽  
Giovanni Rezza

2018 ◽  
Vol 107 ◽  
pp. 14-20 ◽  
Author(s):  
Ann N. Burchell ◽  
Claire E. Kendall ◽  
Stephanie Y. Cheng ◽  
Aisha Lofters ◽  
Michelle Cotterchio ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Birye Dessalegn Mekonnen

Background. Women living with human immunodeficiency virus (HIV) are more likely to develop an increased risk of invasive cervical cancer. Morbidity and mortality due to cervical cancer could be reduced with early detection through cervical screening. Though uptake of cervical screening was investigated in Ethiopia, inconsistent findings were reported. Therefore, this systematic review and meta-analysis was designed to estimate the pooled prevalence of cervical cancer screening uptake among HIV-positive women and its associated factors in Ethiopia. Methods. A comprehensive search of PubMed/MEDLINE, Scopus, EMBASE, CINAHL, Google Scholar, Science Direct, and Cochrane Library was conducted. The data were extracted using a standardized data extraction format. Statistical analysis was done using the STATA, version 14, software. The heterogeneity of the studies was assessed using the I2 test. Funnel plots and Egger’s test were used to check publication bias. A random effects model was computed to estimate the pooled prevalence of cervical cancer screening uptake. Moreover, pooled odds ratios with 95% confidence intervals were used to determine the association of identified determinant factors with cervical cancer screening uptake. Results. A total of 10358 studies were retrieved, and 7 studies were included in the meta-analysis. The pooled prevalence of cervical cancer screening uptake among HIV-positive women in Ethiopia was 18.17% (95% CI : 11.23, 25.10) with exhibited heterogeneity (I2 = 96.6%; p<0.001). Educational status of women (AOR = 3.50; 95% CI : 1.85, 6.07), knowledge of women on cervical cancer (AOR = 3.26; 95% CI : 2.50, 4.43), and perceived susceptibility (AOR = 3.26; 95% CI : 2.26, 4.26) were significantly associated with cervical cancer screening uptake among HIV-positive women. Conclusion. The uptake of cervical cancer screening among HIV-positive women in Ethiopia was low. The findings of this study suggest the need to improve the existing national strategies of cervical cancer screening so as to strengthen reproductive health education and promotion, in addition to providing screening services. Furthermore, cervical screening service should be integrated to the routine care and treatment, so that HIV-positive women can get counseling services in every clinical contact.


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