Risk Factors Associated with Invasive Cervical Carcinoma among Women Attending Jimma University Specialized Hospital, Southwest Ethiopia A Case Control Study

Abstract

BACKGROUND: Cervical cancer is a more serious public health problem than other cancers in womenin Sub-Saharan Africa in general and in Ethiopia in particular. Thus, this study assessed risk factorsrelated to invasive cervical carcinomas in southwestern Ethiopia.METHODS: Unmatched case control study was conducted in Jimma University Specialized Hospitalfrom April 1 to September 30, 2010. The study consisted of 60 cases (women who had cervical cancersbased on histopathologic examination) and 120 controls (women with no cervical cancers). Semi-structured questionnaire was utilized for data collection. Vaginal examinations often visualized withspeculum insertions were done for both cases and controls. Punch cervical biopsies were then performedfor the suspected cases at Jimma University Hospital that serves about 15 million people in a catchmentradius of 250 kms. Data were analyzed using SPSS version 13.0 software. Univariate and multivariateanalyes were done to describe and identify independent predictors of cervical cancer.RESULTS: The mean ages of cases and controls were 47.7 (SD=10.8) and 35.5 (SD =10.5) yearsrespectively. Older women (40-59 years), (OR= 4.7; 95%CI= 2.3-9.6), more than one husband (OR= 2.0;95%CI=1.0-3.9), as well as more than one wife in lifetime, (OR= 3.0; 95% CI= 1.5-5.9), women whohad more than 4 children, (OR =10.3, 95% CI= 3.6-29.0), and age greater than 25 years at first full termdelivery, (OR= 8.8; 95% CI= 3.5-22.0) were statistically significant and the latter two were independentlyassociated with invasive cervical cancer. Only 7(11.7 %) of cases and 58(48.3%) of controls ever heard ofcervical cancers; however, 2(3.3%) of cases and 7(5.8%) of controls had ever had history ofpapaneocolous (pap) smear tests done.CONCLUSION: Poor knowledge on cervical cancer was observed that required more work to be done toincrease knowledge of mothers on cervical cancer and on associated risk factors. Behavioralcommunication activities and establishment of cervical cancer screening programs for the young couldhelp reduce the advancement of cervical cancer particularly among the less knowledgeable, older andgrand multiparous women in our parts of the world.