Secondary prevention of cervical cancer by screen-and-treat approach among HIV negative women in Faith Alive Hospital, Jos Nigeria
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232714Keywords:
Faith Alive, HIV negative, Screen-and-treat, VIAAbstract
Background: Cervical cancer is the second most common cancer among women in Nigeria and the leading cause of cancer-related death in sub-Saharan Africa. In low-income settings, visual inspections with acetic acid (VIA) and Lugol’s iodine (VILI); and subsequent treatment of cervical precancerous lesions with thermal ablation remains the practical approach for secondary prevention. Objectives were to determine prevalence of pre-cancerous cervical lesions, prevalence of suspected cervical cancer, and associated risk factors.
Methods: A retrospective study on sexually active HIV negative women aged 16-55 years screened for cervical cancer using VIA/VILI within 16 months period in Faith Alive Hospital Jos. Data were analyzed using IBM-SPSS 26. Socio-demographic characteristics and screening results were presented in frequency tables; and logistic regression was performed to determine risk factors for cervical pre-cancerous lesions.
Results: 1,073 HIV negative women were screened for cervical cancer using VIA/VILI. 82 (7.6%) tested positive, 30 (2.8%) had suspected cancer with modal age distribution of 36-45 years. Higher positivity yield (58.6%) was found in ages between 36 and ≥55 years while the less positivity yield (41.4%) was found ages ≤35 years. Parity ≥3 had 1.8 fold risk association with precancerous lesion.
Conclusions: Our study revealed high prevalence of cervical pre-cancerous lesions among HIV negative women, modal age distribution for suspected cancer and parity ≥3 being significant risk factor. Thus, “screen-and-treat” approach to cervical cancer prevention by VIA/VILI and thermal ablation in resource constraint settings should be undertaken until widespread HPV testing to triage clients is possible.
References
Shiferaw N, Salvador-Davila G, Kassahun K, Brooks MI, Weldegebreal T, Tilahun Y, et al. The single-visit approach as a cervical cancer prevention strategy among women with HIV in Ethiopia: successes and lessons learned. Glob Health Sci Pract. 2016;4(1):87-98.
Destaw A, Midaksa M, Addissie A, Kantelhardt EJ, Gizaw M. Cervical cancer screening “see and treat approach”: real-life uptake after invitation and associated factors at health facilities in Gondar, Northwest Ethiopia. BMC Cancer. 2021;21(1):1031.
Lemu LG, Woldu BF, Eshetu Teke N, Bogale ND, Wondimenew EA. Precancerous cervical lesions among HIV-infected women attending HIV care and treatment clinics in southwest Ethopia: a cross-sectional study. Int J Women Health. 2021;13:297-303
Kassa LS, Dile WM, Zenebe GK, Berta AM. Precancerous lesions of cervix among women infected with HIV in referral hospitals of Amhara Region, northwest Ethiopia: a cross sectional study. Afr Health Sci. 2019;19(1):1695-704.
Stuart A, Obiri-Yeboah D, Adu-Sarkodie Y, Hayfron-Benjamin A, Akorsu AD, Mayaud P. Knowledge and experience of a cohort of HIV-positive and HIV-negative Ghanaian women after undergoing human papillomavirus and cervical cancer screening. BMC Women Health. 2019;19(1):123.
Ebu NI, Ogah JK. Predictors of cervical cancer screening intention of HIV-positive women in the central region of Ghana. BMC Women Health. 2018;18(1):43.
Enyan NIE, Akaba S, Amoo SA. Women diagnosed with HIV and unknown HIV status perceived susceptibility to cervical cancer and perceived benefits of cervical cancer screening in Ghana: a cross-sectional study. BMC Women Health. 2021;21(1):367.
Solomon K, Tamire M, Kaba M. Predictors of cervical cancer screening practice among HIV positive women attending adult anti-retroviral treatment clinics in Bishoftu town, Ethiopia: the application of a health belief model. BMC Cancer. 2019;19(1):989.
Tagne Simo R, Kiafon FB, Nangue C, Goura AP, Ebune JL, Usani MC, et al. Influence of HIV infection on the distribution of high-risk HPV types among women with cervical precancerous lesions in Yaounde, Cameroon. Int J Infect Dis. 2021;110:426-32.
International Agency for Research on Cancer (IARC). (2020). Cervix Uteri. The Global Cancer Observatory. Available from: https://gco.iarc.fr/today/data/factsheets/cancers/23-Cervix-uteri-fact-sheet.pdf. Accessed on 22 May 2023.
Datchoua Moukam AM, Embolo Owono MS, Kenfack B, Vassilakos P, Petignat P, Sormani J, et al. “Cervical cancer screening: awareness is not enough”. Understanding barriers to screening among women in West Cameroon-a qualitative study using focus groups. Reprod Health. 2021;18(1):147.
IARC. (2020). Nigeria. The Global Cancer Observatory. Available from: https://gco.iarc.fr/today/data/factsheets/populations/566-nigeria-factsheet.pdf. Accessed on 22 May 2023.
Isa Modibbo F, Dareng E, Bamisaye P, Jedy-Agba E, Adewole A, Oyeneyin L, et al. Qualitative study of barriers to cervical cancer screening among Nigerian women. BMJ Open. 2016;6(1):e008533.
Khadim N, Diegane TJ, Ousmane T, Toly L, Bintou DF, Ibra DA, et al. Factors associated with the use of cervical cancer screening in the Mbour Health District (Senegal). Open J Obstet Gynecology. 2020;10(04):604.
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem and its associated goals and targets for the period 2020-2030. Geneva: World Health Organization; 2020.
Pry JM, Manasyan A, Kapambwe S, Taghavi K, Duran-Frigola M, Mwanahamuntu M, et al. Cervical cancer screening outcomes in Zambia, 2010-19: a cohort study. Lancet Glob Health. 2021;9(6):e832-40.
Kiros M, Mesfin Belay D, Getu S, Hailemichael W, Esmael A, Andualem H, et al. Prevalence and determinants of pre-cancerous cervical lesion and human papillomavirus among HIV-infected and HIV-uninfected women in north-west Ethiopia: a comparative retrospective cross-sectional study. HIV AIDS. 2021;13:719-725
Jolly PE, Mthethwa-Hleta S, Padilla LA, Pettis J, Winston S, Akinyemiju TF, et al. Screening, prevalence, and risk factors for cervical lesions among HIV positive and HIV negative women in Swaziland. BMC Public Health. 2017;17(1):1-8.
Gabaza C, Chonzi P, Chadambuka A, Shambira G, Juru TP, Gombe NT, et al. Utilization and outcomes of cervical cancer screening services in Harare City, 2012–2016: a secondary data analysis. BMC Health Serv Res. 2019;19(1):1-8.
Daniel GO, Musa J, Akindigh TM, Shinku F, Shuaibu SI, Kwaghe B, et al. Prevalence and predictors of precancerous cervical lesions among HIV‐positive women in Jos, north‐central Nigeria. Int J Gynecol Obstet. 2020;151(2):253-9.
Korn AK, Muzingwani L, O’Bryan G, Ensminger A, Boylan AD, Kafidi EL, et al. Cervical cancer screening and treatment, HIV infection, and age: Program implementation in seven regions of Namibia. PloS One. 2022;17(2):e0263920.
Lewis S, Mphande M, Chibwana F, Gumbo T, Banda BA, Sigauke H, et al. Association of HIV status and treatment characteristics with VIA screening outcomes in Malawi: a retrospective analysis. PloS One. 2022;17(1):e0262904.
Poli UR, Bidinger PD, Gowrishankar S. Visual inspection with acetic acid (VIA) screening program: 7 years experience in early detection of cervical cancer and pre-cancers in rural south India. Indian J Community Med. 2015;40(3):203-7.
Alsbeih, G. Exploring the causes of the low incidence of cervical cancer in western Asia. Asian Pac J Cancer Prevent. 2018;19(6):1425-9.