Prevalence of Cancerous and Pre-malignant Lesions of Cervical Cancer and their Association with Risk Factors as seen among women in the Regions of Uganda

Abstract

Cervical cancer is the second cause of death among women in Uganda. Little is known about the prevalence and risk factors associated with cancerous and pre-malignant lesions of cervical cancer in the regions of Uganda. Methods: A cross sectional survey was carried out in the regions of Uganda. Women who reported to Gynecology Clinics were consecutively screened for cancerous and pre-malignant lesions using the Papanicolaou method. A structured questionnaire was used to collect data on risk factors. The power of associations between the risk factors and cancerous and pre-malignant lesions of cervical cancer were determined using the odds ratio and 95% confidence interval. The p value <0.05 was considered as statistically significant. Results: Prevalence of 1.2% of cancerous and 11.2% of pre-malignant lesions was detected in all the regions. The risk factors for both cancerous and premalignant lesions were: Early coitus (OR 3.03, CI:1.01.10-10.05; p<0.024) and (OR 1.41 CI:0.98-2.20; p<0.032) respectively, sexually transmitted infections (STDs) (OR 6.07, CI: 1.77-27.22; p<0.001) and (OR 6.52, CI:4.33-9.10; p<0.001) respectively, polygamy (OR 3.13, CI: 0.98-11.77; p<0.027) and (OR 2.74, CI:1.71-4.43; p<0.001) correspondingly, alcohol (OR 3.72, CI: 1.19-13.77; p<0.011) and (OR 1.71, CI:1.20-2.47; p<0.001) respectively, increased sexual partners (OR 8.03, CI:2.20-53.1; p<0.001) and (OR 3.69, CI:2.51-5.48; p<0.001) respectively. Smoking and high parity were risk factor for only cancerous lesions. Although there was no statistical difference between women who had married more than once and those who had single marriage , the likelihood that women who had married more than once would get cancerous and premalignant lesions was high (OR 1.18, p<0.389) and (OR 1.36, p<0.122) respectively. Conclusion and Recommendations: Age at 1st coitus, STDs, polygamy, smoking, increased sexual partners and alcohol were the risk factors for cancerous and premalignant lesions. Sensitization of the communities and regularly screening for cervical cancer should be encouraged for its control and management.