Risk scoring for selective screening of cervical cancer
AbstractContext: Cervical cancer is the leading cause of cancer related mortality in developing countries. The lack of routine cytological screening in developing countries is largely responsible for this high mortality.
Objectives: To develop a risk score that would easily identify women at greater risk of having cervical intraepithelial neoplasia (CIN) for use in selective population screening.
Study Design, Setting and Subjects: This is a cross sectional study carried out in two tertiary institutions in Northern Nigeria.One thousand one hundred and twenty-nine women attending clinics at two Teaching Hospitals in Nigeria were randomly screened for CIN. Each had a pap smear taken for cytology after a questionnaire had been filled.
Results: There were 1129 questionnaires administered during the study period. The mean age was 28.9±6.8 years. The majority, 61.9% had no formal education and 76.2% were unemployed housewives of low socio economic class. The risk factors that showed statistically significant relationship with CIN were number of marriages (OR = 12.6, P=0.006), polygamy (OR = 21.7,P=0.001), premarital coitus (OR = 30.0,P=0.001), coital frequency (OR = 30.9,P=0.002), number of sexual partners (OR = 35.9,P=0.003), parity (OR = 51.4,P=0.001), coitarche (OR = 52.8,P=0.020), age at first marriage (OR = 78.1,P=0.001) and age (OR = 107.9,P=0.001).
Conclusion: Risk scoring can help filter those women at high risk of cervical neoplasia from history alone during clinic visits. This is particularly beneficial in resource poor settings with highly competing health demands, hence improving the sensitivity and specificity of screening by selectively targeting population at risk.
Keywords: Cervical cancer, risk score, selective screening
The entire contents of the Tropical Journal of Obstetrics and Gynaecology are protected under Indian and international copyrights. The Journal, however, grants to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, perform and display the work publicly and to make and distribute derivative works in any digital medium for any reasonable non-commercial purpose, subject to proper attribution of authorship and ownership of the rights. The journal also grants the right to make small numbers of printed copies for their personal non-commercial use.
This journal content is distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.