A Decade Of Cervical Cancer Screening At The Jos University Teaching Hospital

Abstract

Background: Cervical cancer is the second most common cause of death from cancer in women globally. This has made its prevention and treatment an area of priority for decades, if not centuries. Despite overwhelming evidence demonstrating the effectiveness of screening programs, African countries in general, and Nigeria in particular, that bear the largest burden of cervical cancer have been unable to fully integrate cervical cancer screening exercises into their health systems. In 2007, a cervical cancer screening program was commenced at the Jos University Teaching Hospital in Jos, Plateau state Nigeria to address the screening gap and hopefully reduce the burden of cervical cancer. The aim of this review was to evaluate the cervical cancer screening program at the Jos University Teaching Hospital, Jos, Plateau State, Nigeria, assess the challenges and effectiveness with a view to upscaling into a national programme. Settings and Design: The study was conducted in Jos, Plateau State, North Central Nigeria among women who had Papanicolaou smears, colposcopy, and biopsies done at the oncology unit of the Department of Obstetrics & Gynaecology of the Jos University Teaching Hospital from 2007-2017. Methods and Material: This was a retrospective observational study. Results: Sixteen-thousand and thirty-eight (16,038) women had Papanicolaou smears over the period. Of these, 13,153(83.1%) were negative for intraepithelial neoplasia, 1119(7.1%) showed various forms of atypical dysplasia (ASCUS, ASC-H, AGSUS), 901(5.7%) were Low-grade squamous intraepithelial lesions (LGSIL), 332(2.1%) were high-grade intraepithelial lesions (HGSIL) and 318(2.0%) had other findings. There were 457 histologically diagnosed cancers in the 10 years since the screening program commenced, of which squamous cell carcinoma (82.3%) was the most common histologic diagnosis. Conclusions: Though many women have been integrated into cervical cancer-screening program of the Jos University Teaching Hospital it still covers just a minor proportion of the over-all population in the state