Bezabih Mesele, Tessema Fasil, Sengi Hailemariam, Deribew Amare
Department of Medical laboratory Sciences and Pathology, Jimma University, Ethiopia.
Department of Epidemiology and Biostatistics, Jimma University, Ethiopia.
Ethiop J Health Sci. 2015 Oct;25(4):345-52. doi: 10.4314/ejhs.v25i4.8.
Cervical cancer is a more serious public health problem than other cancers in women in Sub-Saharan Africa in general and in Ethiopia in particular. Thus, this study assessed risk factors related to invasive cervical carcinomas in southwestern Ethiopia.
Unmatched case control study was conducted in Jimma University Specialized Hospital from April 1 to September 30, 2010. The study consisted of 60 cases (women who had cervical cancers based on histopathologic examination) and 120 controls (women with no cervical cancers). Semi-structured questionnaire was utilized for data collection. Vaginal examinations often visualized with speculum insertions were done for both cases and controls. Punch cervical biopsies were then performed for the suspected cases at Jimma University Hospital that serves about 15 million people in a catchment radius of 250 kms. Data were analyzed using SPSS version 13.0 software. Univariate and multivariate analyes were done to describe and identify independent predictors of cervical cancer.
The mean ages of cases and controls were 47.7 (SD=10.8) and 35.5 (SD =10.5) years respectively. Older women (40-59 years), (OR= 4.7; 95%CI= 2.3-9.6), more than one husband (OR= 2.0; 95%CI=1.0-3.9), as well as more than one wife in lifetime, (OR= 3.0; 95% CI= 1.5-5.9), women who had more than 4 children, (OR =10.3, 95% CI= 3.6-29.0), and age greater than 25 years at first full term delivery, (OR= 8.8; 95% CI= 3.5-22.0) were statistically significant and the latter two were independently associated with invasive cervical cancer. Only 7(11.7 %) of cases and 58(48.3%) of controls ever heard of cervical cancers; however, 2(3.3%) of cases and 7(5.8%) of controls had ever had history of papaneocolous (pap) smear tests done.
Poor knowledge on cervical cancer was observed that required more work to be done to increase knowledge of mothers on cervical cancer and on associated risk factors. Behavioral communication activities and establishment of cervical cancer screening programs for the young could help reduce the advancement of cervical cancer particularly among the less knowledgeable, older and grand multiparous women in our parts of the world.
总体而言，在撒哈拉以南非洲地区，尤其是在埃塞俄比亚，宫颈癌是比其他女性癌症更为严重的公共卫生问题。因此，本研究评估了埃塞俄比亚西南部浸润性宫颈癌的相关危险因素。
2010年4月1日至9月30日在吉姆马大学专科医院开展了非匹配病例对照研究。该研究包括60例病例（经组织病理学检查确诊为宫颈癌的女性）和120例对照（无宫颈癌的女性）。采用半结构化问卷收集数据。对病例和对照均进行了常借助阴道窥器插入进行的阴道检查。然后在服务约1500万人、覆盖半径达250公里的吉姆马大学医院，对疑似病例进行宫颈活检。使用SPSS 13.0软件进行数据分析。进行单因素和多因素分析以描述和确定宫颈癌的独立预测因素。
病例组和对照组的平均年龄分别为47.7岁（标准差 = 10.8）和35.5岁（标准差 = 10.5）。年龄较大的女性（40 - 59岁）（比值比 = 4.7；95%置信区间 = 2.3 - 9.6）、有多个丈夫（比值比 = 2.0；95%置信区间 = 1.0 - 3.9）、一生中拥有多个妻子（比值比 = 3.0；95%置信区间 = 1.5 - 5.9）、生育4个以上子女的女性（比值比 = 10.3，95%置信区间 = 3.6 - 29.0）以及首次足月分娩年龄大于25岁（比值比 = 8.8；95%置信区间 = 3.5 - 22.0）具有统计学意义，后两者与浸润性宫颈癌独立相关。仅7例（11.7%）病例和58例（48.3%）对照听说过宫颈癌；然而只有2例（3.3%）病例和7例（5.8%）对照曾有过巴氏涂片检查史。
观察到对宫颈癌的认知较差，需要开展更多工作以提高母亲们对宫颈癌及其相关危险因素的认知。开展行为沟通活动并为年轻人建立宫颈癌筛查项目，有助于减少宫颈癌的进展，特别是在我们所在地区知识水平较低、年龄较大和多产的女性中。
