Prevalence of cervical cancer and pre-cancerous lesions among unscreened Women in Kumasi, Ghana

Abstract

Ghana does not have a universal population-based cervical cancer screening program and there is very limited information about the distribution of cervical epithelial cell lesions. This study provides evidence that a moderately high prevalence of cervical cancer and precancerous lesions exists among unscreened women in Kumasi. The prevalence of cervical epithelial cell abnormalities among a cross-section of women attending cervical cancer screening for the first time in a suburb of Ghana from 2011 to 2014 was studied. Cervical smears were prepared and examined independently by 2 cytotechnologists and confirmed by a pathologist. Cervical lesions were classified according to the Bethesda System for cervical cytology 2001. Out of the 592 women for whom a Pap smear was available for evaluation, 555 (93.8%) were negative for intraepithelial lesion or malignancy. Eight women (1.4%) showed atypical squamous cells of undetermined significance (ASCUS), 9 (1.4%) low-grade squamous intraepithelial lesions, and 2 (0.3%) high-grade squamous intraepithelial lesions. A total of 15 (2.5%) smears were unsatisfactory for cervical cytology. Additionally, 3 women (0.5%) had squamous cell carcinoma, giving an overall rate of 3.7% for epithelial cell abnormalities. Cervical cancer and precursor epithelial cell abnormalities are common among women in Kumasi for a disease that can be prevented by early detection through routine screening and management. This study provides adequate background data to recommend the implementation of cervical cancer screening in all eligible women in Ghana.

Prevalence and predictors of precancerous cervical lesions among HIV‐positive women in Jos, north‐central Nigeria

“…Although smoking and use of contraceptives have been reported to be established co‐factors for HPV progression to cervical lesions, 23 in the present study, the association between precancerous cervical lesions and these two factors was not significant, probably related to the very low prevalence of smoking among women in the study population. The observation of a significant association between age and parity as risk factors of SILs among these women is an indication that the dynamics of interaction between risk factors may be different in this population.…”

Cervical cancer: Automation of Pap test screening

“…When using only the Pap test as a screening method, the percentage of samples with lesions is 3% to 10% 104‐107 . On the other hand, the combination of hrHPV test, AM, and Pap test allows increasing the number of samples with lesions to 50% to 85%, 101,102 which increases the representativeness of pre‐relevant neoplasms for the algorithm, making it more sensitive 108,109 .…”

A comparative study to see the effectiveness of Pap smear, visual inspection with 3-5% acetic acid and its confirmation by cervical biopsy

“…Carcinoma cervix is the second most common cancer in developing countries like India it is most important cancer among the women in past two decades by now it is known that the accessibility of uterine cervix, propensity of cells to exfoliate from precancerous lesion, the evidence from pathological studies of existence of histological changes from mild atypia through premalignancy to the frank malignancy, the apparently prolonged natural history the long premalignant phase and the ability for detecting changes using potential for control of cervical cancer. [10][11][12] It is assured that cervical intraepithelial neoplasia (CIN) acts as a premalignant disease and progress slowly over a period of 15-20 years to invasive cancer. Immense attention has been paid to natural history of cancer cervix and it has been proved beyond doubt that during the course of development of the disease there is sufficiently large period in which it is absolutely curable.…”