Identifying the risk factors for cervical cancer in Rwanda: A case control study

Abstract

Background: Identifying the risk factors for cervical cancer in a specific community informs the design of prevention programs adapted to the local
context. Published such data are not available in Rwanda.

Objective: This study aimed to describe the risk factors for cervical cancer in Rwanda.

Design: Case control study

Setting: The study was conducted at the gynecologic oncology clinic of a University Teaching Hospital in Kigali. Population: Patients who attended the gyn-oncology clinic from January 2014 to December 2018.

Method: Files of patients with histopathology-confirmed cervical cancer (cases) were matched with patients with no cervical cancer diagnosis  controls) by age (±1 year) at a ratio of one to two and were examined for relevant information. Backward stepwise logistic regression was conducted to detect associations between risk factors and diagnosis of cervical cancer.

Results: A total of 243 patient files were reviewed and 94.6% had no prior cervical cancer screening. The odds of cases having a secondary education were 0.15 times (OR=0.15, 95%CI: 0.04-0.058, p<0.01) the odds of the controls. The odds of cases being in moderate socioeconomic class were 0.37 times (OR=0.37, 95%CI: 0.17-0.82, p=0.01) compared to controls. The odds of cases being HIV positive were 10.83 times that of controls (OR=10.83, 95%CI: 3.19-36.78, p<0.01).

Conclusion: This study found that the socioeconomic status, including formal education level attained, prior screening, and HIV sero-positivity were associated with development of cervical cancer in Rwanda. Cervical cancer education and screening programs should consider these factors and serve the high-risk population.