Factors Associated with Invasive Cervical Carcinoma in Jimma University Specialized Hospital, South Western Ethiopia: A Case Control Study.

Abstract

Background: Cervical cancer is the most common cancer in women of the developing world. The etiological factors of cervical cancers have been described in many populations of the world but very few researches have targeted sub-Saharan populations. Various modifiable risk factors may have influence in women with invasive cervical carcinoma and this type of risk factors assessment has not been reported in Ethiopia. Thus, this study attempted to assess some of the risk factors related to invasive cervical carcinomas in southwestern part of Ethiopia. Methods and materials: Unmatched case control study was conducted within Jimma University Specialized Hospital from April to September 2010 where a sample size of 180 study participants (60 cases and 120 controls) was included in the study. Cases were women who have had cervical carcinoma based on pathological examinations where as, controls were those women who had other diseases other than cervical cancer. Data were collected by use of a pretested structured questionnaire. Punch cervical biopsies for the suspected cases were delivered to Pathology unit within Department of Laboratory sciences and pathology. Data were analyzed by use of SPSS version 13.0 statistical soft ware package. P-Value was considered significant when it was less than 0.05. RESULTS: The independent predictor variables identified in this study were parity for more than 4 children AOR =8.2, (95% CI, 1.5-42.6; p-value, 0.012), the age at first full term delivery (more than 25 years of age) AOR= 4.5, (95% CI= 1.2=16.4; p-value =0.024) as well as study participants’ occupation (farming) AOR =4.7, (95% CI 1.6-13.5). The most common reason for late coming to JUSH for both cases and controls was ignorance 82 (55.8%). Seven (11.7 %) of cases have ever heard of cervical cancers and only 2 (3.3%) of them had history of PAP smear tests done.4 CONCLUSION Parity and the age at first full term pregnancy were among the most important risk factors for the development of invasive cervical cancers in this study. The age at first full term pregnancy was an independent predictor at older (>25) age in contradistinction of some studies but, compounded by narrowing the intervals among succeeding child births may help fasten the development of invasive cervical carcinomas in the study population. Thus, it can be extrapolated in that not only the increasing parity that is important for the development of cervical cancer but also the timing of intervals among children need to be considered as an important variable for invasive cervical cancer studies in the future. On the other hand, awareness of cervical cancer, and availability of effective screening programmes could reduce cervical cancer burden among susceptible women