Most women diagnosed with cervical cancer by a visual screening program in Tanzania completed treatment: evidence from a retrospective cohort study

BMC Public Health

Siobán D Harlow³  Robert M Chamberlain¹  Crispin Kahesa²  Julius Mwaiselage²  Twalib Ngoma²  Amr S Soliman¹  Andrew C Gard³ 

[1] University of Nebraska Medical Center College of Public Health, Omaha, NE, USA;Ocean Road Cancer Institute, Dar es Salaam, Tanzania;University of Michigan School of Public Health, Ann Arbor, MI, USA

关键词: Tanzania;    Radiation therapy;    Referral patterns;    Visual inspection with acetic acid;    Screening;    Cervical cancer;   

Others  :  1128035
DOI  :  10.1186/1471-2458-14-910

 received in 2013-07-01, accepted in 2014-07-29,  发布年份 2014

【 摘 要 】

Background

Visual inspection with acetic acid (VIA) to identify and treat pre-cancerous lesions is effective for cervical cancer prevention. Screening programs also facilitate screening and diagnosis of invasive cancers that must be referred for radiation therapy or chemotherapy. This study compared characteristics of women diagnosed with invasive cervical cancer by a VIA screening program who did and did not follow up for treatment and who did and did not complete treatment at the Ocean Road Cancer Institute (ORCI), Dar es Salaam, Tanzania.

Methods

We conducted a retrospective cohort study of ORCI screening referrals from the period November 2002 to June 2011. Women referred for treatment of invasive disease (n = 980) were identified from an existing database of all women attending the screening clinic during this period (n = 20,131) and matched to a dataset of all cervical cancer patients attending ORCI in this period (n = 8,240). Treatment information was abstracted from patient records of women who followed up. Records of a random sample (n = 333) of unscreened patients were reviewed for disease stage.

Results

Of the 980 women referred women, 829 (84.6%) sought treatment. Most of those women (82.8%) completed their prescribed radiation. Lower disease stage, having a skilled occupation, residence in Dar es Salaam, and younger age were independently associated with loss to follow-up. Higher disease stage, residence in Dar es Salaam, older age, and later year of first treatment appointment were independently associated with incomplete treatment among those who followed up. Significantly more screened women had stage 1 disease (14.0%) than unscreened women (7.8%).

Conclusions

Most women referred from the screening clinic completed treatment for their cancer at ORCI. Some of those lost to follow-up may have sought treatment elsewhere. In most cases, the screening clinic appears to facilitate diagnosis and treatment, rather than screening, for women with invasive cervical cancer.

【 授权许可】

   
2014 Gard et al.; licensee BioMed Central Ltd.

【 图 表 】

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