Makerere University, College of Health Sciences, Kampala, Uganda.
Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
JCO Glob Oncol. 2021 Jul;7:1116-1128. doi: 10.1200/GO.21.00123.
In East Africa, cervical cancer is a leading cause of morbidity and mortality among women diagnosed with cancer. In this study, we describe the burden of risk factors for cervical cancer among women of reproductive age in five East African countries.
For each country, using STATA13 software and sampling weights, we analyzed the latest Demographic and Health Survey data sets conducted between 2014 and 2017 in Burundi, Kenya, Rwanda, Tanzania, and Uganda. We included women age 15-49 years and considered six risk factors (tobacco use, body mass index, age at first sexual intercourse, age at first birth, number of children, and hormonal contraceptive use).
Of the 93,616 women from the five countries, each country had more than half of the women younger than 30 years and lived in rural areas. Pooled proportion of women with at least one risk factor was 89% (95% CI, 87 to 91). Living in a rural area in Burundi (adjusted incidence rate ration 0.94; 95% CI, 0.9 to 0.99; = .019) and Rwanda (adjusted incidence rate Ration 0.92; 95% CI, 0.88 to 0.96; < .001) was associated with a lower number of risk factors compared with living in an urban area. In all the countries, women with complete secondary education were associated with a lower number of risk factors compared with those with no education.
This study reveals a high burden of risk factors for cervical cancer in East Africa, with a high proportion of women exposed to at least one risk factor. There is a need for interventions to reduce the exposure of women to these risk factors.
在东非,宫颈癌是妇女癌症患者发病率和死亡率的主要原因。本研究描述了五个东非国家育龄妇女宫颈癌相关风险因素的负担。
我们使用 STATA13 软件和抽样权重,对布隆迪、肯尼亚、卢旺达、坦桑尼亚和乌干达五个国家在 2014 年至 2017 年期间开展的最新人口与健康调查数据进行了分析。我们纳入了年龄在 15-49 岁的女性,并考虑了 6 种风险因素(吸烟、体重指数、初次性交年龄、初次生育年龄、子女数量和激素避孕使用情况)。
在来自这五个国家的 93616 名女性中,每个国家都有超过一半的女性年龄小于 30 岁,居住在农村地区。五个国家合并的至少存在一个风险因素的女性比例为 89%(95%置信区间,87-91)。与居住在城市地区的女性相比,居住在农村地区的布隆迪(调整后的发病率比值 0.94;95%置信区间,0.9-0.99;=0.019)和卢旺达(调整后的发病率比值 0.92;95%置信区间,0.88-0.96;<0.001)的女性风险因素数量较少。在所有国家中,与未接受教育的女性相比,完成中等教育的女性的风险因素数量较少。
本研究揭示了东非宫颈癌风险因素负担沉重,大多数女性至少存在一种风险因素。需要采取干预措施,减少女性接触这些风险因素。