Factors associated with cervical precancerous lesions among women screened for cervical cancer in Addis Ababa, Ethiopia: A case control study

Abstract

BackgroundCervical cancer is the second most prevalent cancer among women in the developing countries including Ethiopia. Precancerous lesions can be developed and risk to the development of cervical cancer over time. Early identification of the precancerous lesion and its risk factor is paramount in preventing cervical cancer. However, the determinants of cervical precancerous lesions are not well documented in Ethiopia. Therefore, this study is conducted to determine factors associated with cervical precancerous lesion among women screened for cervical cancer.MethodsA hospital-based unmatched case-control study was conducted in selected health facilities in Addis Ababa from March to April 2016. Data were collected from 114 cases and 229 controls using an interviewer-administered questionnaire, entered to Epi Info version 7, and exported to SPSS version 20 for analysis. Odds ratios with its 95% confidence intervals and two-tailed P-value were calculated. Variables with P-value ≤ 0.2 in the bivariate analysis were included in the multivariate logistic regression model.ResultsWomen aged 40–49 years had 2.4-fold higher odds of precancerous lesions compared to those aged 30–39 (Adjusted Odds Ratio = 2.4, 95% Confidence Interval: 1.27–4.54). Women having history of sexually transmitted infections were significantly associated with cervical precancerous lesion compared to their counterparts (Adjusted Odds Ratio = 3.20, 95% Confidence Interval: 1.26–8.10). Similarly, those women who had two or more lifetime sexual partners (Adjusted Odds Ratio = 2.17 95% Confidence Interval: 1.01–4.67), and women whose husbands had two or more lifetime sexual partners (Adjusted Odds Ratio = 3.03, 95% Confidence Interval: 1.25, 7.33) had higher odds of cervical precancerous lesions.ConclusionsOlder age, history of multiple sexual partners and sexual transmitted infections were associated with increased risk of precancerous lesion. Therefore, women with higher risk of precancerous lesions should be encouraged to be screened more frequently for cervical cancer.

Magnitude and Factors Associated with Precervical Cancer among Screened Women in Southern Ethiopia

“…Early onset of sexual activity is thought to be associated with high risk because, during puberty, cervical tissue undergoes physiologic changes, transformation zone on the ecto-cervix is enlarged, and exposure to HPV at such times may facilitate infection which may make this area more vulnerable to development of dysplasia, a cervical squamous precancer. In addition an earlier age of sexual debut implies a longer period of sexual activity a higher likelihood of having many sexual partners and it is inconsistent with study conducted at Addis Ababa [16]. This difference could be due to the differences in the age distribution of study populations, sexual practice or could be due to the sociocultural difference and settings.…”

Burden of cervical lesion in Ethiopia: Systematic review and meta-analysis

“…The following items were used to appraise cross-sectional studies: [1] inclusion criteria; [2] description of study subject and setting; [3] valid and reliable measurement of exposure; [4] objective and standard criteria used; [5] identification of confounder; [6] strategies to handle confounder; [7] outcome measurement; and [8] appropriate statistical analysis. In addition, JBI Systematic Reviews checklist for case control studies (41) using ten items were used to appraise one case control study (42). Studies considered low risk whenever fitted to 50% and or above quality assessment checklist criteria's (40,43).…”

“…Among the total 15 studies included to the current review, five of them were from Addis Ababa City Administration (17,42,(48)(49)(50). Five studies were included from the Southern Nations Nationalities and People Region (SNNPR) (51-55).…”

“…Five studies were included from the Southern Nations Nationalities and People Region (SNNPR) (51-55). Except one study (42), all the rest included studies were conducted using cross sectional study design. Most of the studies used VIA as the measure of assessment tool for the outcome variable.…”

A Review of Various Methods of Predicting Cervical Cancer

“…Parthenis et al [10] gives another reason for causes of cervical cancer is Sexually Transmitted Diseases (STDs) also leads to the same. Teame et al [11] identified that age of the women above 38 years with STD history are becoming the victims of cervical cancer. Since no symptoms of cervical cancer are known by the women at its earlier stage, its leads to their life loss Okunowo et al [12].…”