Journal of
Cancer Research and Experimental Oncology

  • Abbreviation: J. Cancer Res. Exp. Oncol.
  • Language: English
  • ISSN: 2141-2243
  • DOI: 10.5897/JCREO
  • Start Year: 2009
  • Published Articles: 56

Full Length Research Paper

Assessment of alternative approaches of primary cervical cancer screening among women in low-income environments

Emmanuel Eilu
  • Emmanuel Eilu
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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Saheed Adekunle Akinola
  • Saheed Adekunle Akinola
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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Julius Tibyangye
  • Julius Tibyangye
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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Rasheed Omotayo Adeyemo
  • Rasheed Omotayo Adeyemo
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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Martin Odoki
  • Martin Odoki
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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Aliero Almustapha Adamu
  • Aliero Almustapha Adamu
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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Sarah Kemuma Onkoba
  • Sarah Kemuma Onkoba
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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Moindi Jeridah Kemunto
  • Moindi Jeridah Kemunto
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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Ismail Adebayo Abyola
  • Ismail Adebayo Abyola
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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Charles Drago Kato
  • Charles Drago Kato
  • Department of Microbiology and Immunology, Kampala International University, Western Campus, P. O. Box 71 Ishaka - Bushenyi, Uganda.
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  •  Received: 13 April 2020
  •  Accepted: 14 April 2021
  •  Published: 31 May 2021

Abstract

Alternative techniques for detecting cancer of the cervix uteri alongside its early precancerous lesions still remain necessary for low income environments since morbidity and mortality due to cervical cancer continues to be on the rise. We recruited one thousand and seventy-seven women aged 15-55 years from selected study hospitals in Eastern Uganda and examined them using Papanicolaou (Pap) smear, direct visual inspection with 5% acetic acid solution (VIA), and human papillomavirus (HPV) DNA testing. Study participants detected with high-grade lesions (HSIL) or cancer cells on Pap smear test, positive VIA test (acetowhite lesions, cervical ulcer or growth), and positive high-risk HPV DNA (relative light units (RLU) were immediately scheduled for colposcopy and cervical biopsy. Of the forty percent of the women confirmed with pap smear positive, 43 of the 63 women had invasive carcinoma (68.3%), while 89 out of 137 women with confirmed biopsy were diagnosed with high grade CIN (CIN2,3) (65%). DVI identified 46 of 63 carcinomas (73%) as well as 47 of 74 high grades CIN (CIN 2, 3) (64%). There was a variation in HPV DNA results due to the cutoff value considered in defining the final result. HPV DNA of high-risk HPV types was detected 39 (61.9%) out the 63 women diagnosed invasive cervical cancer, while 66 (73.3%) or 46 (51%) was detected in the biopsy of women diagnosed with high grade CIN (CIN 2,3). Similarity in identification of high-grade cervical abnormalities was registered by the testing methods. Both VIA and HPV genetic testing methods diagnosed similar numbers of high grade CIN 2,3 and invasive cancer cases as Pap smears. Nevertheless, individual test methods categorized study participants with no cervical disease as being positive.

Key words: Visual inspection with acetic acid (VIA), cervical intraepithelial neoplasia (CIN), human papillomavirus (HPV).