Age Prevalence of Cervical Cancer: Implications for Cervical Cancer Screening in Under-Screened Population

Abstract

Introduction: Cervical cancer remains a major cause of cancer mortality in low-income countries. There are peculiar challenges in screening under-screened populations because a large number of older women would have to be screened. The appropriate screening method for such population must be cost effective and near accurate for all age groups. Materials and Methods: Records of all women diagnosed of cervical cancer in our hospital over a period of eight years were retrieved. Their ages, the clinical stage of their disease and the histological diagnosis were extracted and analyzed. Results: Cervical cancer cases (174) were seen over this period. In the same period, 9600 patients were admitted in the Gynaecology ward of the hospital. Cervical cancer constituted 1.81% of the admissions. The mean age was 60.92years. Women ≥60 years were 108 (62%), 50-59years were 37(21%), 40-49years were 21(12%) and those ≤39years were 8 (5%). Majority 148 (85.1%) had stage ≥2B and only 26 (15%) had operable stage ≤2A. Most were squamous cell carcinoma, 148S (85.1%) followed by adenocarcinoma,14 (8.1%). Verrucous carcinoma was seen only in women in their 50s and clear cell carcinoma in 60years and above. All cell types were more in the older women except the verrucous subtype. Conclusion: The hospital prevalence of cervical cancer is still high in our centre and age prevalence is higher among older women compared to what obtains in screened populations. This peculiarity therefore has implications for the choice of screening method.