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卢旺达宫颈癌及癌前病变的患病率和危险因素

Prevalence and risk factors for cervical cancer and pre-cancerous lesions in Rwanda.

作者信息

Makuza Jean Damascène, Nsanzimana Sabin, Muhimpundu Marie Aimee, Pace Lydia Eleanor, Ntaganira Joseph, Riedel David James

机构信息

Rwanda Biomedical Center, Kigali, Rwanda.

Brigham and Women's Hospital, Boston, MA, USA.

出版信息

Pan Afr Med J. 2015 Sep 11;22:26. doi: 10.11604/pamj.2015.22.26.7116. eCollection 2015.

Abstract

INTRODUCTION

Cervical cancer prevalence in Rwanda has not been well-described. Visual inspection with acetic acid or Lugol solution has been shown to be effective for cervical cancer screening in low resource settings. The aim of the study is to understand the prevalence and risk factors for cervical cancer and pre- cancerous lesions among Rwandan women between 30 and 50 old undergoing screening.

METHODS

This cross-sectional analytical study was done in 3 districts of Rwanda from October 2010 to June 2013. Women aged 30 to 50 years screened for cervical cancer by trained doctors, nurses and midwives. Prevalence of pre-cancerous and cancerous cervical lesions was determined. Bivariate and multivariate logistic regressions were used to assess risk factors associated with cervical cancer.

RESULTS

The prevalence of pre-cancer and invasive cervical cancer was 5.9% (95% CI 4.5, 7.5) and 1.7% (95% CI 0.9, 2.5), respectively. Risk factors associated with cervical cancer in multivariate analysis included initiation of sexual activity at less than 20 years (OR=1.75; 95% CI=(1.01, 3.03); being unmarried (single, divorced and widowed) (OR=3.29; 95% CI=( 1.26, 8.60)); Older age of participants (OR= 0.52; 95% CI= (0.28, 0.97)), older age at the first pregnancy (OR=2.10; 95% CI=(1.20, 3.67) and higher number of children born (OR=0.42; 95%CI =(0.23, 0.76)) were protective.

CONCLUSION

Cervical cancer continues to be a public health problem in Rwanda, but screening using VIA is practical and feasible even in rural settings.

摘要

引言

卢旺达宫颈癌的患病率尚未得到充分描述。在资源匮乏地区,用醋酸或卢戈氏溶液进行目视检查已被证明对宫颈癌筛查有效。本研究的目的是了解30至50岁接受筛查的卢旺达女性中宫颈癌及癌前病变的患病率和危险因素。

方法

这项横断面分析研究于2010年10月至2013年6月在卢旺达的3个地区进行。30至50岁的女性由经过培训的医生、护士和助产士进行宫颈癌筛查。确定癌前和癌性宫颈病变的患病率。采用双变量和多变量逻辑回归评估与宫颈癌相关的危险因素。

结果

癌前病变和浸润性宫颈癌的患病率分别为5.9%(95%可信区间4.5, 7.5)和1.7%(95%可信区间0.9, 2.5)。多变量分析中与宫颈癌相关的危险因素包括20岁之前开始性行为(比值比=1.75;95%可信区间=(1.01, 3.03));未婚(单身、离婚和丧偶)(比值比=3.29;95%可信区间=( 1.26, 8.60));参与者年龄较大(比值比= 0.52;95%可信区间= (0.28, 0.97)),首次怀孕年龄较大(比值比=2.10;95%可信区间=(1.20, 3.67))以及生育子女数较多(比值比=0.42;95%可信区间 =(0.23, 0.76))具有保护作用。

结论

宫颈癌在卢旺达仍然是一个公共卫生问题,但即使在农村地区,使用醋酸目视检查法进行筛查也是切实可行的。

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