Cervical Cancer Screening in Enugu, Nigeria.

Abstract

Context: Though preventable by early detection and treatment of the pre-invasive stage, carcinoma of the cervix remains the commonest gynaecological malignancy in Nigeria and a leading cause of death among women. The preventive role of cervical cancer screening is directly related to the proportion of the population screened.


Objective: To present the results of cervical cancer screening by Pap smear in a highly subsidized screening centre in Nigeria and to determine the characteristics of the women with positive cervical smear.


Study Design:A ten-year descriptive analysis of women availing themselves of the cervical cancer screening service at the Medical Women Centre in Enugu, South Eastern Nigeria.


Main Outcome Measures: Women's response; the proportion and characteristics of women with abnormal smears.


Results: Over a ten-year period (1991-2000), 815 women had Pap smears at the Medical Women Centre in Enugu of whom only 4 (0.5%) ever had a previous smear. The prevalence of abnormal smears was 12.2%, the proportion rising with increasing age and doubling after the age of 54 years. All the women with positive smears were or had been coitally active; 97% were parous and 81% grand multiparous.


Conclusion: The utilisation of the subsidised cervical cancer screening service in Enugu is very poor. The high prevalence of positive smears and the increased rates with increasing age may be related to the absence of an effective screening programme in Nigeria. Collective effort to increase the number of women screened is advocated, pending the establishment of a national cervical cancer-screening program.


Key Words: Cervical Cancer, Screening, Papanicolaou Smears.


[Trop J Obstet Gynaecol, 2003, 20: 109-112]