Publication:

Secondary prevention of cervical cancer by screen-and-treat approach among HIV negative women in Faith Alive Hospital, Jos Nigeria

Background Cervical cancer is the second most common cancer among women in Nigeria and the leading cause of cancer-related death in sub-Saharan Africa.  In low-income settings, visual inspections with acetic acid (VIA) and Lugol’s iodine (VILI); and subsequent treatment of cervical precancerous lesions with thermal ablation remains the practical approach for secondary prevention. Objectives were to determine prevalence of pre-cancerous cervical lesions, prevalence of suspected cervical cancer, and associated risk factors.

Methods A retrospective study on sexually active HIV negative women aged 16-55 years screened for cervical cancer using VIA/VILI within 16 months period in Faith Alive Hospital Jos.  Data were analyzed using IBM-SPSS 26. Socio-demographic characteristics and screening results were presented in frequency tables; and logistic regression was performed to determine risk factors for cervical pre-cancerous lesions.

Results 1,073 HIV negative women were screened for cervical cancer using VIA/VILI. 82 (7.6%) tested positive, 30 (2.8%) had suspected cancer with modal age distribution of 36-45 years. Higher positivity yield (58.6%) was found in ages between 36 and ≥55 years while the less positivity yield (41.4%) was found ages ≤35 years. Parity ≥3 had 1.8 fold risk association with precancerous lesion.

Conclusions Our study revealed high prevalence of cervical pre-cancerous lesions among HIV negative women, modal age distribution for suspected cancer and parity ≥3 being significant risk factor. Thus, “screen-and-treat” approach to cervical cancer prevention by VIA/VILI and thermal ablation in resource constraint settings should be undertaken until widespread HPV testing to triage clients is possible.