| dc.description.abstract |
Abstract; Background: Cervical cancer is the second leading type of female cancer in Ethiopia. Screening is primarily conducted using visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) has not yet been used in Ethiopia.Method: Women aged 21-65 years were tested using LBC and VIA for the detection of cervical dysplasia. Logistic regression analysis was conducted to identify associated factors. Cohen’s K test was conducted to test agreement between LBC and VIA. Results: Forty-two percent (n=188) of 448 participants were 31 to 40 years of age and only two participants were above 60. Of the 448 participants, 419 (93.5%) were tested with LBC, 294 (65.6%) VIA and 272 (60.7%) with both LBC and VIA. Among women screened using LBC, 305(72.8%) were negative for intraepithelial lesion or malignancy (NILM), 97 (23.2%) had low grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) high grade squamous intraepithelial lesion (HSIL). Presence of cervical lesions was generally lower in younger and older aged women. Majority, 39(40%) with LSIL and 10 (59%) of women with HSIL were 41-50 years old. Women aged 51-60 years were more likely to have abnormal intraepithelial lesions compared to women aged 21-30 (AOR= 20.9,95%CI=[7.2-60.9], p=0.00). Out of 47 (10.8%) HIV-patients,14(32.56%) had intraepithelial lesion of which 10(23.3%) and 4(9.3%) had LSIL and HSIL, respectively. Among women screened with VIA, 18 (6.1%) were positive. Among the 272 (60.7%) women screened using both LBC and VIA, 6 (2.2%) were positive on both LBC and VIA. The level of agreement between the two tests was weak and statistically significant (kappa value=0.155, p=0.006). Conclusion: LBC detected high cervical squamous intra-epithelial lesions in our setting. VIA was a less reliable predictor of cervical squamous intra-epithelial lesions than LBC. Evaluating diagnostic accuracy of both LBC and VIA against histological endpoint should be completed before adopting either screening modalities. |
|