Analysis of the Kadoma General Hospital Cervical Cancer Screening Program Dataset, 2014-2015

Download Article

DOI: 10.21522/TIJPH.2013.04.02.Art050

Authors : Pamela N. Magande


Analysis of the Kadoma General Hospital Cervical Cancer Screening Program Dataset, 2014-2015

Pamela N. Magande, Daniel Chirundu, Notion Gombe, More Mungati, Donewell Bangure, Mufuta Tshimanga

Introduction: Early diagnosis of cervical cancer results in successful treatment. Visual Inspection with acetic Acid and Cervicography (VIAC) is an effective method of cervical cancer screening being used in Zimbabwe. In Kadoma screening started in 2014, 2506 clients had been screened in July 2015. Factors associated with VIAC positivity were determined since VIAC positivity was low, 3%.

Materials and methods: An analytical cross sectional study based on secondary dataset analysis was conducted in 2015. All the 2506 clients were included. The data was exported from an electronic database into Epi Info 7TM (CDC. 2014). Frequencies and means were generated using this software. Bivariate analysis and multilogistic regression were also performed.

Results: Among the clients who were screened, 81% were married. The median age was 39.7 years (Q1 =31; Q3=47). The median number of children was two (Q1 =2; Q3 =4). Early sexual debut, <16 years (POR=2.37(1.47-3.83), p value<0.05), being single (POR=1.92(1.21-3.12), p value=0.005), being HIV positive (POR=3.87(2.40-6.23), p< 0.05), history of STI (POR=1.83(1.05-3.15), p=0.03), (POR=2.79(1.17-6.65), p value=0.015) were significant risk factors. The significant protective factor was having one sexual partner (POR=0.45(0.29-0.70), p value<0.05). The independent risk factor was being HIV positive (aOR=4.16(2.56-6.77), p value <0.05). The independent protective factors were delaying sexual debut, aOR=0.53 (0.32-0.87), p value =0.012 and regular condom use aOR=0.28 (0.086-0.92), p value=0.036.

Conclusion: VIAC should be routine care for the HIV positive. Efforts should be intensified to promote delaying sexual debut and prevent STIs.


[1.] Ajah LO, Chigbu CO, Ozumba BC, Oguanuo TC, Ezeonu PO,(2015) Is there any association between hormonal contraceptives and cervical neoplasia in a poor Nigerian setting?, Dove Press Journal, , OncoTargets and Therapy, 8, 1887–1892.

[2.] Basu PS, Sankaranarayanan R, Mandal R, Roy C, Das P, Choudhury D,; (2003)Visual inspection with acetic acid and cytology in the early detection of cervical neoplasia in Kolkata, India. Calcutta Cervical Cancer Early Detection Group, International Journal of Gynecological Cancer, 13(5): 626-32.

[3.] Brown B, Bristow C, Iñiguez R.I, Magis-Rodriguez C, Silverman J.G, Meckel-Parker K, et. al, (2015)Prevalence And Risk Factors Of Cervical Abnormalities Among Female Sex Workers In Mexico, International Papillomavirus Conference. Lisbon, Portugal, .

[4.] Biswas LN, Manna B, Maiti PK, Sengupta S, (1997)Sexual risk factors for cervical cancer among rural Indian women: a case-control study, Int J Epidemiol. 26(3):491-5.

[5.] Betram CC, (2004) Evidence for practice: oral contraception and risk of cervical cancer, J Am Acad Nurse Pract. 16(10):455-61.

[6.] Coker A, McCann MS, Hulka BS,Walton LA, (1992) Oral contraceptive use and cervical intraepithelial neoplasia , J Clin Epidemiol;45(10):1111-8.

[7.] Chokunonga E, Borok M.Z, Chirenje Z.M, Nyakabau A.M, Zimbabwe Cancer Registry, 2010, 14

[8.] Franceschi S, Dal Maso L, Arniani S, Crosignani P, Vercelli M, Simonato ,et al (1998),Risk factors for cancer other than Kaposi’s sarcoma in persons with AIDS in Italy. Cancer and AIDS Registry Linkage Study, Br J Cancer 78:966–970

[9.] Global Cancer Facts & Figures, : American Cancer Society; 2011, 2nd Edition, page 1,24

[10.] Gunguwo T.(2006) Zimbabwe Manual for Cervical cancer screening, Ministry of Health and Child Welfare Zimbabwe (MOHCW) and UNFPA, , 12-24

[11.] Gedefaw A, Astatkie A, Tessema GA, (2013)The Prevalence of Precancerous Cervical Cancer Lesion among HIV-Infected Women in Southern Ethiopia: A Cross-Sectional Study, PLoS ONE ,8(12)

[12.] Holmes RS, Hawes SE, Touré P, Dem A, Feng Q, Weiss NS et. al, (2009),HIV Infection as a Risk Factor for Cervical Cancer and Cervical Intraepithelial Neoplasia in Senegal, Cancer Epidemiol Biomarkers Prev , 18; 2442

[13.] Huchko MJ, Leslie H,Sneden J, Maloba M, Abdulrahim N, Bukusi EA and Cohen CR, (2014), Risk factors for cervical precancer detection among previously unscreened HIV-infected women in Western Kenya, International Journal of Cancer; 134(3): 740–745

[14.] International Agency for Research against Cancer, GLOBOCAN 2012, Estimated Cancer Incidence, Mortality and Prevalence in 2012, Accessed 25 August 2015

[15.] Key Informant Dr Madzima, Director Family Health Services, Ministry of Health and Child Care, Zimbabwe

[16.] Leck I, Sibary K, Wakefield J,(1978) Incidence of cervical cancer by marital status, J Epidemiol Community Health, 32(2): 108–110.

[17.] Likes W, Itano J, (2003)Human papillomavirus and cervical cancer: not just a sexually transmitted disease, Clin J Oncol Nurs, 7(3):271-6

[18.] Memiah P, Mbuthia W,Kiiru G, Agbor S, Odhiambo F,Ojoo S,3 and Biadgilign S,(2012) Prevalence and Risk Factors Associated with Precancerous Cervical Cancer Lesions among HIV-Infected Women in Resource-Limited Settings, , AIDS Research and Treatment, 7

[19.] Makuza JD, Nsanzimana S, Muhimpundu MA, Pace LE, Ntaganira J, Riedel DJ, Prevalence and risk factors for cervical cancer and pre-cancerous lesions in Rwanda, The Pan African Medical Journal;22:26

[20.] Murthy NS, Mathew A,(2000) Risk factors for pre-cancerous lesions of the cervix. Eur J Cancer Prev. 9 (1):5-14.

[21.] Sankaranarayanan R, Wesley R, Somanathan T, Dhakad N, Shyamalakumary B, Amma NS, Parkin DM, Nair MK(1998), Visual inspection of the uterine cervix after the application of acetic acid in the detection of cervical carcinoma and its precursors, Cancer. ;83(10):2150-6.

[22.] Schiffman M, Wentzensen N, Wacholder S, Kinney W, Gage JC, Castle P. (2011)Human Papillomavirus Testing in the Prevention of Cervical Cancer, Oxford University Press, .

[23.] Sellors J, Lewis K, Kidula N, Muhombe K, Tsu V, Herdman C (2003) Screening and Management of Pre-Cancerous Lesions To Prevent Cervical Cancer in Low-Resource Settings, Asian Pacific Journal of Cancer Prevention, Volume 4, 3:277-280

[24.] Vere M, Shambira G,(2013) Risk Factors for Cervical Pre-cancer Lesions among Women Attending Cervical Cancer Screening Clinics in Harare, University of Zimbabwe, , unpublished.

[25.] World Health Organisation News, WHO supports introduction of HPV vaccine in Zimbabwe, Accessed 27 August 2015

[26.] World Health Organisation, (2006)International Agency for Research against Cancer Handbook Cancer Prevention, Volume 10 Cervix Cancer Screenings ,59-109

[27.] Wiley DJ, Douglas J, Beutner K, Cox T, Fife K, Moscicki AB,et. al. (2002), External Genital Warts: Diagnosis, Treatment, and Prevention, Clin Infect Dis, 35 (Supplement 2): S210-S224

[28.] Zondervan KT, Carpenter LM, Painter R and Vessey MP,(1996) Oral contraceptives and cervical cancer -further findings from the Oxford Family Planning Association contraceptive study, British Journal of Cancer, 73, 1291-1297

[29.] Zimbabwe National Statistics Agency (ZIMSTAT) and ICF International.( 2012) Zimbabwe Demographic and Health Survey 2010-11. Calverton, Maryland: ZIMSTAT and ICF International Inc.