The cervical smear pattern in patients with chronic pelvic inflammatory disease.

BACKGROUND: Cancer of the cervix is the commonest malignancy of the genital tract in Nigeria. In an atmosphere of opportunistic screening due to lack of a national screening programme, studies are needed to determine patients at risk of premalignant lesions of the cervix. GOAL: To determine cervical smear pattern in patients with chronic pelvic inflammatory disease and investigate the potential of chronic pelvic inflammatory disease as a risk factor to cervical dysplasia. STUDY DESIGN: Case-control study. SETTING: Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital Zaria, Nigeria. SUBJECTS: Three hundred and sixty-nine premenopausal women attending the gynaecologic and family planning clinics of Ahmadu Bello University Teaching Hospital Zaria, Nigeria from January to December 2000. RESULTS: Of the 369 women that had cervical cytology by Pap smear, 163 (44%) had chronic pelvic inflammatory disease (cases) while 206 (56%) were non chronic PID patients (control). There was no statistical significance in the mean age between the two groups. The mean age at first coitus and marriage of all the women were 17.92.7 years and 18.5 3.4 years respectively. There were 52 dysplastic smears encountered, giving a prevalence rate of 140/1,000 or 14% for Cervical Intraepithelial Neoplasia. There were higher cases of dysplasia in the chronic PID group than in the control and this differences was statistically significant (p<0.05). Other risk factors to dysplasia identified include high parity (>4) and age of first coitus less than 20 years. Only 10% of all the women screened were aware of both cervical cancer and Pap smear. CONCLUSION: Women with chronic pelvic inflammatory disease are probably at higher risk of developing cervical dysplasia than women without chronic pelvic inflammatory disease. Cervical cancer screening programmes should be intensified in chronic pelvic inflammatory disease patients. However, further studies are needed in our setting to verify the association between pelvic inflammatory disease and cervical dysplasia.

Sociodemographic and clinicopathologic characterization of cervical cancers in northern Nigeria.

OBJECTIVE: To evaluate the sociodemographic and clinicopathological characteristics of patients with cervical cancer seen in a tertiary referral center in northern Nigeria. MATERIALS AND METHODS: Between January 2002 and December 2004, 70 consecutive patients with histologically confirmed cervical cancer, with a median age of 48 years (range, 30-75 years), were interviewed on the basis of a structured pro forma. RESULTS: Of these patents, 39 (56%) had had no formal education, and 36 (51%) were unemployed housewives. Sixty (86%) had become sexually active before 17 years of age; 44 (63%) were in polygamous families, and 25 (36%) patients were in at least a second marriage. There was an average of 6.8 live births per patient. Vaginal bleeding was seen in all patients, and 55 (79%) had vaginal discharges; 50 (71%) had a bulky cervical mass, and 46 (66%) presented with at least Stage IIIA disease. Squamous cell carcinoma was the commonest histology. The three HIV-seropositive patients were young and had advanced disease. CONCLUSION: Sociodemographic factors, such as low socioeconomic level, early age at first sexual intercourse and multiple sexual partners, place women at high risk of developing cervical cancer in northern Nigeria. Late presentation with advanced disease predominates.