Factors associated with late-stage presentation of cervical cancer in Ghana

Factors Influencing Cervical Cancer Screening: A Cross-Sectional Study Among Ethnically Diverse Women in the Kumasi Metropolis of Ghana

Background

Globally, Ghana is one of the countries with the greatest cervical cancer (CC) burdens and mortality rates. Available research has focused primarily on women's experiences in the general population neglecting factors that influence cervical cancer screening (CCS) among ethnically diverse populations in Ghana.

Aim

This study explored the factors influencing CCS among ethnically diverse women in the Kumasi Metropolis of Ghana.

Method

From April to June 2023, a community-based cross-sectional study was carried out in the Aboabo and Asawase communities of the Ashanti Region. Binary and multivariable logistic regressions were employed to determine the relationships between the dependent and independent variables. Outcome variables with p-values < 0.05 were considered statistically significant.

Results

Habits, knowledge, perceived benefits, and facilitating factors influenced CCS among ethnically diverse women. An overall self-reported CCS rate of 7.2% (n = 32) with an early age of sexual initiation of 15-20 years was recorded. While habits (OR = 0.23, 95% CI 0.09, 0.58; p = 0.002), affect (OR = 0.00, 95% CI 0.00, 0.03; p < 0.001), and the perceived benefits of screening (OR = 3.07, 95% Cl 1.01, 10.8; p = 0.059) were associated with CCS. Norms (OR = 0.00, 95% CI 0.00, 20,948,726,859,075; p > 0.9), knowledge (OR = 1.27, 95% CI 0.61, 2.53; p = 0.5), and facilitating factors (OR = 1.02, 95% CI 0.51, 2.01; p > 0.9) were not statistically significant with CCS.

Conclusion

Poor knowledge, lower perceived benefits of CCS, and weak facilitating factors were identified as barriers to CCS. Implementing national CCS and vaccination campaigns to improve awareness, and screening to reduce women's risk is encouraged.

Late Stage at Diagnosis of Cervical Cancer and Its Correlates at a Large Regional Referral Hospital in Uganda: A Cross-Sectional Study

Background The stage of disease at diagnosis is one of the major determinants of survival in women with cervical cancer. Most women with cervical cancer in low- and middle-income countries (LMICs) present to hospitals with advanced stages, thus reducing their survivorship following the diagnosis. Factors correlated with late-stage disease at diagnosis are not completely explored. This study aimed to describe the association between sociodemographic, clinical, and metabolic characteristics with late-stage disease at diagnosis in women with cervical cancer attending the Mbarara Regional Referral Hospital in Southwestern Uganda. Methodology We conducted a cross-sectional study of women with histological diagnoses of invasive cervical cancer between November 2022 and August 2023. Women who presented to the hospital with the International Federation of Gynecology and Obstetrics stage IIb and above were considered to have late-stage cervical cancer while those with stage IIa and below were considered to have early-stage disease. We used modified Poisson regression to determine the factors independently associated with the outcome. Results We enrolled 157 women. The average age of the participants was 52.4 years. The majority of the participants (83.4%) had late-stage disease at diagnosis. Women with adenocarcinoma (adjusted prevalence ratio (aPR) = 1.18, 95% confidence interval (CI) = 1.10-1.38) and those with lymphovascular space involvement on histology (aPR = 1.30, 95% CI = 1.05-1.60) were more likely to have late-stage disease at diagnosis while women living with human immunodeficiency virus (aPR = 0.83, 95% CI = 0.71-0.97) were less likely to present with late-stage disease at diagnosis. None of the sociodemographic and metabolic characteristics were associated with late-stage disease at diagnosis. Conclusions The number of women presenting with late-stage cervical cancer is high. Efforts to increase the availability and uptake of cervical cancer screening services in LMICs should be reinforced. Cervical cancer treatment services should be decentralized to increase accessibility.