Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study
Abstract Background Cervical cancer is the leading and most common female cancer among women in Ghana. Although there are screening methods to detect premalignant lesions for treatment, screening coverage in Ghana is 2.8% and late presentation of cases complicates treatment efforts. This study exami...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-10-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-018-6065-6 |
| _version_ | 1819072077212155904 |
|---|---|
| author | Priscilla Dunyo Kofi Effah Emilia Asuquo Udofia |
| author_facet | Priscilla Dunyo Kofi Effah Emilia Asuquo Udofia |
| author_sort | Priscilla Dunyo |
| collection | DOAJ |
| description | Abstract Background Cervical cancer is the leading and most common female cancer among women in Ghana. Although there are screening methods to detect premalignant lesions for treatment, screening coverage in Ghana is 2.8% and late presentation of cases complicates treatment efforts. This study examined the sociodemographic, clinical and histological characteristics associated with late presentation of cervical cancer cases attending Gynecological Oncology care at Catholic Hospital, Battor. Methods One hundred and fifty-seven medical records of confirmed cases of cervical cancer reporting to the Outpatient Obstetrics and Gynecology Department between 2012 and 2016 were reviewed. Relevant data were retrieved using abstraction forms. Socio demographic variables investigated were level of education attained, marital status, National Health Insurance Scheme membership, employment status, place of residence and distance from hospital. Clinical variables included intermenstrual/postmenopausal bleeding, previous screening history, previous smoking history, age at menarche and number of children. Histological variables included subtypes of tumour and characteristics of tumour. Pearson’s chi-square test and logistic regression analysis were used to determine correlates of late stage at presentation with cervical cancer. Sensitivity analysis was performed to assess the effect of missing data. Results Approximately two-thirds (65.97%) of the cases presented in advanced stages of cervical cancer. Level of education, age at menarche and previous screening history were included in a regression model and adjusted for age. Age at menarche (n = 66) was eliminated from the model after sensitivity analysis. Among the remaining variables, only previous screening history was predictive of late stage at presentation of cervical cancer cases. Previously unscreened cases of cervical cancer were nearly four times more likely to present late, compared to those who had been screened previously (OR 3.91; 95% CI 1.43–10.69). No association was observed with sociodemographic and histological characteristics. Conclusion Lack of previous screening was associated with late presentation of cervical cancer at Catholic Hospital, Battor. Efforts to promote early cervical cancer screening should be intensified and future studies may explore an association with age at menarche. |
| first_indexed | 2024-12-21T17:31:59Z |
| format | Article |
| id | doaj.art-053fde1656da4f5eb3c80006e541e129 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-21T17:31:59Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-053fde1656da4f5eb3c80006e541e1292022-12-21T18:55:53ZengBMCBMC Public Health1471-24582018-10-0118111010.1186/s12889-018-6065-6Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective studyPriscilla Dunyo0Kofi Effah1Emilia Asuquo Udofia2Department of Population, Family and Reproductive Health, School of Public Health, University of GhanaObstetric and Gynecological Department/Cervical Cancer Screening and Training Center, Catholic HospitalDepartment of Community Health, School of Public Health, University of GhanaAbstract Background Cervical cancer is the leading and most common female cancer among women in Ghana. Although there are screening methods to detect premalignant lesions for treatment, screening coverage in Ghana is 2.8% and late presentation of cases complicates treatment efforts. This study examined the sociodemographic, clinical and histological characteristics associated with late presentation of cervical cancer cases attending Gynecological Oncology care at Catholic Hospital, Battor. Methods One hundred and fifty-seven medical records of confirmed cases of cervical cancer reporting to the Outpatient Obstetrics and Gynecology Department between 2012 and 2016 were reviewed. Relevant data were retrieved using abstraction forms. Socio demographic variables investigated were level of education attained, marital status, National Health Insurance Scheme membership, employment status, place of residence and distance from hospital. Clinical variables included intermenstrual/postmenopausal bleeding, previous screening history, previous smoking history, age at menarche and number of children. Histological variables included subtypes of tumour and characteristics of tumour. Pearson’s chi-square test and logistic regression analysis were used to determine correlates of late stage at presentation with cervical cancer. Sensitivity analysis was performed to assess the effect of missing data. Results Approximately two-thirds (65.97%) of the cases presented in advanced stages of cervical cancer. Level of education, age at menarche and previous screening history were included in a regression model and adjusted for age. Age at menarche (n = 66) was eliminated from the model after sensitivity analysis. Among the remaining variables, only previous screening history was predictive of late stage at presentation of cervical cancer cases. Previously unscreened cases of cervical cancer were nearly four times more likely to present late, compared to those who had been screened previously (OR 3.91; 95% CI 1.43–10.69). No association was observed with sociodemographic and histological characteristics. Conclusion Lack of previous screening was associated with late presentation of cervical cancer at Catholic Hospital, Battor. Efforts to promote early cervical cancer screening should be intensified and future studies may explore an association with age at menarche.http://link.springer.com/article/10.1186/s12889-018-6065-6Cervical cancerGhanaOncologyScreeningPrevention |
| spellingShingle | Priscilla Dunyo Kofi Effah Emilia Asuquo Udofia Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study BMC Public Health Cervical cancer Ghana Oncology Screening Prevention |
| title | Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study |
| title_full | Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study |
| title_fullStr | Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study |
| title_full_unstemmed | Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study |
| title_short | Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study |
| title_sort | factors associated with late presentation of cervical cancer cases at a district hospital a retrospective study |
| topic | Cervical cancer Ghana Oncology Screening Prevention |
| url | http://link.springer.com/article/10.1186/s12889-018-6065-6 |
| work_keys_str_mv | AT priscilladunyo factorsassociatedwithlatepresentationofcervicalcancercasesatadistricthospitalaretrospectivestudy AT kofieffah factorsassociatedwithlatepresentationofcervicalcancercasesatadistricthospitalaretrospectivestudy AT emiliaasuquoudofia factorsassociatedwithlatepresentationofcervicalcancercasesatadistricthospitalaretrospectivestudy |