Prevalence of cervical intraepithelial neoplasia and its associated factors among women attending healthcare services in Eastern Uganda

Abstract

Cervical malignancy is still the leading cause of death for middle-aged women in the developing world. In Uganda, literature has shown that, cervical cancer incidence and death rates was 45.6 and 25 per 100,000 women respectively. However, the actual magnitude of cervical malignancy in Uganda might be higher since most of the cases are never reported. This study assessed the prevalence of cervical intraepithelial neoplasia among women from hospitals in Eastern Uganda. This was a longitudinal study, with follow-up until diagnosis of high-grade cervical intraepithelial neoplasia (CIN). One thousand and seventy seven women aged 15-55 years were recruited into the study. Pap-smear tests were conducted on all study participants. Women who had abnormal cytology were referred for immediate colposcopic and histological assessment. Surveillance was maintained on these women, and treatment postponed, until there was histological evidence of high-grade CIN (CIN2 or CIN3). At that point women were treated. Those that were pap smear negative were advised to return for screening for three consecutive negative smears before they were allowed to leave the study. Factors associated with cervical cancer were obtained by use of questionnaires. The general prevalence of CIN among women in Eastern Uganda was 416/1077 (38.6%). Two hundred and fourteen, 214/1077(19.9%) had severe CIN3, 180/1077(16.7%) had moderate CIN2, and 22/1077(2.0%) had mild CIN1. Older women aged 45-55-years were frequently diagnosed with the advanced disease stage as compared with young adults aged 15-24 who were less commonly diagnosed with the disease. The study showed that age, use of contraceptives, history of STI and HIV status had statistical significant association with development of cervical intraepithelial neoplasia among the studied participants. There is need for routine surveillance of precancerous lesions and treatment in a timely manner. Key words: Cervical intraepithelial neoplasia, risk factors, cervical cancer.