Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza.

Autor: Kaizilege GK; Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania., Ndaboine E; Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania. ndaboine2@yahoo.com., Chuma C; Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania., Mujuni F; Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania., Kiritta R; Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania., Matovelo D; Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania., Ottoman O; Department of Pathology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania., Elias E; Department of Pathology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania., Masalu N; Department of Oncology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania., Kidenya BR; Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania., Mazigo HD; Department of Parasitology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2024 Jan 12; Vol. 24 (1), pp. 66. Date of Electronic Publication: 2024 Jan 12.
DOI: 10.1186/s12885-023-11779-1
Abstrakt: Background: The single-visit strategy, also known as the "screen-and-treat" approach, is widely used to screen for cervical cancer in low- and middle-income countries. The screen-and-treat approach leads to unnecessary or inadequate treatment. Thus, a study was conducted to determine the histopathological patterns of aceto-white lesions on visual inspection with acetic acid (VIA) in patients who underwent a Loop Electrosurgical Excision Procedure (LEEP) at Bugando Medical Centre between January 2016 and December 2020.
Method: A 5-year retrospective cross-sectional case record review was conducted on 329 women who had LEEP at Bugando Medical Centre following a positive VIA cervical screening test. A standard data abstraction form was used to collect patient information. Missing client information records and LEEP without histopathological results were exclusion criteria. For statistical analysis, STATA version 15 was used; in descriptive statistics, frequency, mean, and standard deviation were used. The Chi 2 and Fisher's exact tests were used to investigate the relationship between patient characteristics and histopathological patterns, and a P-value of 0.05 was considered statistically significant in multinomial models.
Results: This study looked at 329 patients who had LEEP following a VIA positive but were not eligible for cryotherapy. Our study participants had a mean age of 40 ± 8.2 SD. There were 203 (61.7%) patients with benign lesions, including 4 with schistosomiasis and 2 with cervical tuberculosis. The precancerous lesions were discovered in 100 cases (30.4%), and 26 (7.9%) already had invasive cervical cancer. Out of 100 patients with precancerous lesions, 58 (17.6%) and 42 (12.8%) have high- and low-grade squamous intraepithelial (HSIL and LSIL) lesions, respectively. The presence of a precancerous lesion was found to be associated with age 31-40 years (P-value 0.042) and HIV positivity (P-value 0.004).
Conclusion: Most patients in this study had benign cervical lesions, which do not require LEEP treatment. Nonetheless, a considerable percentage of invasive cervical malignancies and rare benign diseases such as schistosomiasis and cervical tuberculosis were identified. A screen-and-treat approach within well-equipped tertiary hospitals like Bugando Medical Centre should explore alternative options instead of relying solely on straight LEEP.
(© 2024. The Author(s).)
Databáze: MEDLINE
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