Prevalence of Cervical Cancer and Associating Factors among HIV Infected Women of Omaruru District in Namibia
Abstract:
In 2015 Namibia reported 55 deaths due to cervical cancer, and the prevalence of HIV was 13,3% among adults aged between 15 -49. There is an increased risk of cervical cancer among women living with HIV, the prevalence of this type of cancer and the association with risk factors is unknown at the Omaruru Hospital. High prevalence of HPV infection, advanced HIV disease, tobacco, multiple sexual partners, parity, and poor socio-economic conditions are listed among contributing factors that increase morbidity and mortality of cervical cancer, which can be controlled & cured if diagnosed early. This research aimed to determine the prevalence of cervical Cancer among HIV-positive women on ARVs and assess the risk factors contributing to the emergence of cervix cancer in this population. The approach methodologic used was a retrospective cross-sectional of 49 women randomly selected among those who were done pap smears at the Omaruru ART clinic between August 2016 to August 2017. There was no positive result for cervical cancers found. Hence, the prevalence of HPV was found to be 16,32%, with Cervical dysplasia 3 cases of CIN I and 5 cases of CIN II with no association established with risk factors, and a case of CIN II in a primigravida with multiple sexual partners were found. To conclude, a meaningful analysis with STATA 14 revealed no positive results for cervical cancer from the 49 cases with no risk factors association established,30.61% of negative HPV (30 - 39 years;28.57% (40-50 years), CIN II aged 30 to 39 years (4%);4% (40- 50 years) 2% above 50 years old. The HPV prevalence (16,32%,),3 cases of CIN 1, and 5 cases of CIN II are indicators that more efforts need to be made.Keywords: Cervical cancer prevalence, Cervical cancer screening, HPV prevalence, HIV women on antiretroviral treatment, primigravida, multiple sexual partners.
References:
[1] Center of Control Diseases
(CD, 2016). Cervical Cancer. Available at: https://www.cdc.gov/cancer/cancer. Access
date (20/12/2017).
[2] Odendal L. (2011). Anti-retroviral therapy reduces
the risk of progression to cervical cancer in women with HIV. Available at: http://www.aidsmap.com/Cervical-cancer-in-women-with-HIV/page/1669155/data.
Access data (23/02/2018).
[3] Center of Disease Control (CDC,2015). Global Statistics.
Available at: https://www.hiv.gov/overview/data-and-trends/global-statistics. Access
date (20/02/2018).
[4] Siegel RL, Miller KD and Jemal. A (2016). Cancer
statistics. Cervical cancer screening and prevention. Available at: contemporaryobgyn.modernmedecine.com/contemporary-obgyn/news/.
Access date (20/02/2018).
[5] Cancer Research UK (2017).
Publications. Available at https://publications.cancerresearchuk.org. Access date
(23/02/2018).
[6] Global Cancer Statistics (2017). CANSA. Available
at: www.cansa.org.za/global-cancer-statistics. Access date (23/02/2018).
[7] World Health Organization (WHO,2012). Human Papillomavirus
(HPV) and Cervical Cancer. Available at: https://www.who.int/mediazantre/factsheets/fs380.
Access date (19/02/2018).
[8] Scott Dryden-Peterson, Memory Bvochora-Nsingo,
Gita Suneja, Jason A. Efstathiou, Surbhi Grover, Sebathu Chiyapo, Doreen Romagola-Masire,
Malebogo Kebabonye-Pusoentsi, Rebecca Clayman, Abigail C. Mapes, Neo Tapea, Aida
Asmelash, Heluf Medhin, Akila N. Viswanathan, Anthony H. Russel, Lilie L. Lin, Mukendi
Kss.A. Kayembe, Mompati Mmalane, Thomas C. Randall, Bruce Chabner and Shahin Lockman
(2016). Journal of Clinical Oncology: HIV infection and survival among women with
Cervical Cancer. Available at http://ascopubs.org/doi/abs/10.1200/JCO.2016.67.9613?journalCode=jco
(Access date 24/05/2017).
[9] Ramadhani S. Chambuso, Stephen Shadrack, Salum
J. Lidenge, Ntoli Mwakibete and Rui M. MedeirosShowMore. Influence of Hiv/AIDS on
Cervical Cancer (2015). A Retrospective Study from Tanzania. Available at: https://ascopubs.org/doi/abs/10.12oo/JGO.2015.002964.
Access date (12/12/20117).
[10] Center of Disease Control (2010). Cervical Cancer Screening
for Wh017o women attends STD Clinic. Available at: http://wwwcdc.gov/sts/treatment/2010/cc-screening.htm.Accessdate
.05/06/2.
[11] Contemporaryobgyn.modernmedecine.com/contemporary-obgyn/news/.
Access date (20/02/2018). Division of STD Prevention (1999). Prevention of genital HPV infection and
sequelae: report of an external consultants’ meeting. Atlanta, GA: Centers
for Disease Control and Prevention. Retrieved December.
[12] Anorlu RI. Cervical cancer: the sub-Saharan African perspective.
2008;16(32):41–9. Available at https://www.cdc.gov/vitalsigns/pdf/2014-11-vitalsigns.pdf(accessed date 06/06/2017).
[13] National Cancer Institute (2016). HIV and Cervical
Cancer Risk. Available at :http://journal.waocp.org/article_47592_359eb14730d5a9bd14e2b38745e045a4.pdf.
Access date (12/12/2017).
[14] Center of
Disease Control (CDC,2017). Cervical cancer screening recommendation and considerations.
Available at: https://www.cdc.gov/cancer/knowledge/provider-education/cervical/recommendations.htm
.Access date (19/02/2018).
[15] CDC (2014).VitalSigns -
Cervical Cancer is Preventable Available
at https://www.cdc.gov/vitalsigns/pdf/2014-11-vitalsigns.pdf(accessed date 06/06/2017).
[16] World
Health Organization (WHO,2017). Guideline for screening and treatment of pre-cancerous
lesion for cervical cancer prevention. Available at :http://apps.who.int/iris/bitstream/handle/10665/94830/9789241548694_eng.pdf;sequence=1.Access
date (24/03/2017).
[17] Namibia
Human Papilloma virus and Related Cancers, Fact Sheet. 2014; [online] [cited available
http://www.hpvcentre.net/statistics/reports/NAM_FS.pdf.(Access date 28/10/2017).
[18] Rosser (2016). Less than half of cervical cancer
patients receive standard of care. Available at: Scott Dryden-Peterson, Memory Bvochora-Nsingo,
Gita Suneja, Jason A. Efstathiou, Surbhi Grover, Sebathu Chiyapo, Doreen Romagola-Masire,
Malebogo Kebabonye-Pusoentsi, Rebecca Clayman, Abigail C. Mapes, Neo Tapea, Aida
Asmelash, Heluf Medhin, Akila N. Viswanathan, Anthony H. Russel, Lilie L. Lin, Mukendi
K.A. Kayembe, Mompati Mmalane, Thomas C. Randall, Bruce Chabner and Shahin Lockman
(2016). Journal of Clinical Oncology: HIV infection
and survival among the woman with Cervical Cancer. Available at http://ascopubs.org/doi/abs/10.1200/JCO.2016.67.9613?journalCode=jco (Access date
24/05/2017).
[19] Namibia
Cancer Registry (2015). Namibia cancer association available at: http://www.can.org.na/cancer-registery/.Access
date (09/02/2018).
[20] United Nations AIDS(UNAIDS,2010). Voluntary Medical
Male Circumcision for HIV prevention. Available at: https://www.avert.org/professionals/hiv-programming/prevention/voluntary-medical-male-circumcision.
Access date (10/03/2017).
[21] Zapata JM, Shabaik, A, .Gascoyne R. (2017). Cervical
cancer is the most common gynecological malignancy. Available at: onlinelibrary.wiley.com/doi/10.1002/cam4.994/full.Access
date (22/02/2018).
[22] AIDSMAP (2015). Cervical cancer in women with HIV. Available
at http://www.aidsmap.com/Cervical-cancer-in women-with-HIV/page/1669155/ (Access
date 24/05/2017).
[23] Clifford G; Franceschi S, Diaz M, Munoza N, V
illa LL(2006). HPV type-distribution in women with and without cervical neoplastic
Diseases. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16950015. Access date
(26/10/2017).
[24] Gilmore T. (2014). Cervical Cancer, Cervical polyp
and cervicitis. Available at: https://www.healthgrades.com/physician/dr-tedra-gilmore-yhhwh
.Access date (09/02/2018)
[25] Urasa and Darj (2011).Knowledge of cervical cancer and screening practices
of nurses at a regional Hospital in Tanzania.
Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092321/(accessed date 05/06/2017).
[26] Mbulaiteye SM, Katabira ET, Wabinga H,
et al. Spectrum of cancers among HIV-infected persons
in Africa: the Uganda AIDS-Cancer Registry Match Study. Int J Cancer. 2006;118(4):985-990.
Available at: http://www.ncbi.nlm.nih.gov/pubmed/16106415.
[27] Frisch M, Biggar RJ, Goedert JJ. Human papillomavirus-associated
cancers in patients with human immunodeficiency virus infection and acquired immunodeficiency
syndrome. J Natl Cancer Inst. 2000;92(18):1500-1510. Available at: http://www.ncbi.nlm.nih.gov/pubmed/10995805.
Access date (19/04/2018).
[28] Ferlay J, Shin HR, Bray F, Forman D, Mathers C,
Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J
Cancer. 2010;127(12):2893–917. View Article PubMed Google Scholar.
[29] De Vuyst H, Alemany L, Lacey C, Chibwesha CJ, Sahasrabuddhe
V, Banura C, et al. The burden of human papillomavirus infections and related diseases
in sub-Saharan Africa. Vaccine. 2013;31 Suppl 5:F32–46.View ArticlePubMed Central.Access
date(23/02/2018)
[30] UNAIDS (2014).Africa Cervical Cancer Incidence & Mortality Multi Indicator ... Available at http://www.who.int/pmnch/media/events/2014/africa_cancer_mortality.pdf(accessed date 06/06/2017) United Nat.
[31] Namibia Fact Sheet. (2014). Millennium challenges
account Namibia. Available at http://www.mcanamibia.org/files/files/Zambesi%20FactSheet%202014Final.pdf (Access date 21/12/2017).
[32] Serraino Diego;Dal Maso Luigino;La Vecchia Carlo;
Franceschi; Silvia (2003).Invasive Cervical cancer as an AIDS-defining illness in
Europe. Available at : https://www.bing.com/search?q=SERRAINO+2003%2C+CERVICAL+CANCER+AND+HIV&qs=n&form=QBRE&sp=-1&pq=serraino+2003%2C+cervical+cancer+and+hiv&sc=0-38&sk=&cvid=C2DF915056A14BD3B7D9819F7C3344A5.Access
date(14/04/2018).
[33] CDC (2013). Cervical Cancer Statistics. Available
at https:// www.cdc.gov/canc er/cervical/statictiss/ (Access date 07/06/2017).
[34] Chatterjee
(2014). A Cross Sectional Study on Knowledge, Attitude
and Practice related to Human Papillomavirus Vaccination for Cervical Cancer Prevention between Medical and Non-Medical Students in Hong Kong.
[35] Every woman Counts (2017). Cervical Cancer prevention
information. Available at: http://www.dhcs.ca.gov/services/Cancer/ewc/Pages/default.aspx.
Access date (13/03/2018).
[36] United Nation AIDS (UNAIDS, 2007). Male circumcision.
Available at http://data.unaids.org/pub/report/2007/jc1360_male_circumcision_en.pdf.
Access date (02/02/2018).