Influence of Demographic and Reproductive Factors on Cervical Pre-Cancer and Cancer in Bangladesh

Nessa, Ashrafun; Ara, Rowson; Fatema, Parveen; Nasrin, Begum; Chowdhury, Afroza; Khan, Kamrul Hasan; Barua, Ashim Ranjan; Rashid, Mohammad Harun Ur

doi:10.31557/APJCP.2020.21.7.1883

Influence of Demographic and Reproductive Factors on Cervical Pre-Cancer and Cancer in Bangladesh

Document Type : Research Articles

Authors

¹ Department of Gynaeclogical Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka-1000, Bangladesh.

² Department of Obstetrics and Gynaecology, BSMMU, Shahbag, Dhaka-1000, Bangladesh.

³ Department of Histopathology, BSMMU, Shahbag, Dhaka-1000, Bangladesh.

⁴ Institute of Epidemiology, Diseese Control and Research (IEDCR), Directorate General of Health Services, Mohakhali, Dhaka-1212, Bangladesh.

10.31557/APJCP.2020.21.7.1883

Abstract

Background: In Bangladesh, cervical cancer (CC) is the 2nd most common cancer with estimated 8068 new cases and 5,214 deaths every year. It is also revealed that different socio-demographic factors have association with CC. This study was performed to evaluate the colposcopy outcomes and the association of different demographic and reproductive risk factors with cervical pre-cancer and cancer. Methods: This retrospective cross-sectional study was carried out at the colposcopy clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) between January 2010 and December 2016. Results: A total 16147 women attended the colposcopy clinic of BSMMU with VIA positive reports. Among them, 65.73% women were referred from different VIA centers of Dhaka district. Mean age of marriage of the subjects was 16. 93 (± 1) and mean age of 1st delivery was 18.45 years (± 4.10). Almost three-fourth of them were married before 18 years and had their 1st delivery by 20 years. Colposcopy examination of the VIA positive women revealed that 36.7% had CINI, 10.6% had CINII/ III and 7.1% had carcinoma of cervix. Considering CIN as disease the Sensitivity, Specificity, PPV and NPV of colposcopy were found 99.7%, 75.3%, 70.3% and 99.8% respectively. On other hand considering CIN2+ as disease the Sensitivity, Specificity, PPV and NPV of colposcopy were found 73.8%, 92.7%, 64.4% and 95.2% respectively. Statistical analysis revealed that higher age (p=0.000), lower level of education (p=0.007), lower socioeconomic status (p=0.014), higher parity (p=0.001) had individual influence on cervical pre-cancer and cancer. Conclusions: This study indicated higher age, low level of education, lower socio-economic condition and higher parity as most important socio-demographic factors for developing cervical pre-cancer and cancer in Bangladesh.

Keywords