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Risk scoring for selective screening of cervical cancer
Abstract
Objectives: To develop a risk score that would easily identify women at greater risk of having cervical intraepithelial neoplasia (CIN) for use in selective population screening.
Study Design, Setting and Subjects: This is a cross sectional study carried out in two tertiary institutions in Northern Nigeria.One thousand one hundred and twenty-nine women attending clinics at two Teaching Hospitals in Nigeria were randomly screened for CIN. Each had a pap smear taken for cytology after a questionnaire had been filled.
Results: There were 1129 questionnaires administered during the study period. The mean age was 28.9±6.8 years. The majority, 61.9% had no formal education and 76.2% were unemployed housewives of low socio economic class. The risk factors that showed statistically significant relationship with CIN were number of marriages (OR = 12.6, P=0.006), polygamy (OR = 21.7,P=0.001), premarital coitus (OR = 30.0,P=0.001), coital frequency (OR = 30.9,P=0.002), number of sexual partners (OR = 35.9,P=0.003), parity (OR = 51.4,P=0.001), coitarche (OR = 52.8,P=0.020), age at first marriage (OR = 78.1,P=0.001) and age (OR = 107.9,P=0.001).
Conclusion: Risk scoring can help filter those women at high risk of cervical neoplasia from history alone during clinic visits. This is particularly beneficial in resource poor settings with highly competing health demands, hence improving the sensitivity and specificity of screening by selectively targeting population at risk.
Keywords: Cervical cancer, risk score, selective screening
