Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza
Abstract 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 his...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-023-11779-1 |
| _version_ | 1827382144492634112 |
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| author | Godfrey K. Kaizilege Edgar Ndaboine Clotilda Chuma Fridolin Mujuni Richard Kiritta Dismas Matovelo Oscar Ottoman Edrick Elias Nestory Masalu Benson R. Kidenya Humphrey D. Mazigo |
| author_facet | Godfrey K. Kaizilege Edgar Ndaboine Clotilda Chuma Fridolin Mujuni Richard Kiritta Dismas Matovelo Oscar Ottoman Edrick Elias Nestory Masalu Benson R. Kidenya Humphrey D. Mazigo |
| author_sort | Godfrey K. Kaizilege |
| collection | DOAJ |
| description | Abstract 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 Chi2 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. |
| first_indexed | 2024-03-08T14:15:18Z |
| format | Article |
| id | doaj.art-8f108576be0e4036a3fb20c03a51541f |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-08T14:15:18Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-8f108576be0e4036a3fb20c03a51541f2024-01-14T12:26:30ZengBMCBMC Cancer1471-24072024-01-012411710.1186/s12885-023-11779-1Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, MwanzaGodfrey K. Kaizilege0Edgar Ndaboine1Clotilda Chuma2Fridolin Mujuni3Richard Kiritta4Dismas Matovelo5Oscar Ottoman6Edrick Elias7Nestory Masalu8Benson R. Kidenya9Humphrey D. Mazigo10Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Pathology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Pathology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Oncology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesDepartment of Parasitology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesAbstract 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 Chi2 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.https://doi.org/10.1186/s12885-023-11779-1VIALEEPPrecancerous lesionsCervical cancer |
| spellingShingle | Godfrey K. Kaizilege Edgar Ndaboine Clotilda Chuma Fridolin Mujuni Richard Kiritta Dismas Matovelo Oscar Ottoman Edrick Elias Nestory Masalu Benson R. Kidenya Humphrey D. Mazigo Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza BMC Cancer VIA LEEP Precancerous lesions Cervical cancer |
| title | Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza |
| title_full | Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza |
| title_fullStr | Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza |
| title_full_unstemmed | Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza |
| title_short | Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza |
| title_sort | unraveling cervical cancer screening dilemmas histopathological insights from via and leep at bugando medical centre mwanza |
| topic | VIA LEEP Precancerous lesions Cervical cancer |
| url | https://doi.org/10.1186/s12885-023-11779-1 |
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