Factors associated with cervical cancer among women attending referral hospitals in Dar es salaam, Tanzania

Abstract

Background: Cervical cancer is the third most common cancer in women, and fourth cause of cancer death in females worldwide. More than 85% of the global burden occurs in sub-Saharan Africa. In Tanzania 35.3% of cancer patients attending Ocean Road Cancer Institute have cervical cancer. HIV constitutes about 21% among cervical cancer patients at ORCI in 2007. Objective: To determine factors associated with cervical cancer among women attending referral hospitals in Dar es Salaam. Methods: This was a hospital based unmatched case control study with a case to control ratio of 1:1. A case was a woman attending Ocean Road Cancer Institute (ORCI) with a confirmed cervical cancer diagnosis in less than 6 months from the day of recruitment. A control was woman attending the Gynaecology clinic at Muhimbili National Hospital with non-cancer related diagnosis. A standardised structured questionnaire was used; data analysis was performed in Epi Info and STATA. Multiple logistic regression models were used to estimate adjusted odds ratios (AORs). Results: A total of 165 cases and 165 controls were included in the study. The mean age ± standard deviation was 51±12 years and 33 ± 11 years among cases and controls respectively. 98 (59.4%) of cases were peasants while 91 (60.7%) of the controls were employed. The HIV prevalence was 42 (28.3%) among cases. Significant risk factors for cervical cancer in our study included lowest wealth quintile (AOR = 6.29; 95% CI: 2.12 – 18.13), peasant (AOR = 6.20; 95% CI: 1.58 – 25.00), occasional post coital genital wash (AOR= 2.8, 95% CI= 1.01 – 7.72) and oral contraceptive use (AOR= 2.29; 95% CI= 1.09 – 5.23). Conclusion: HIV prevalence among cases was quite high. These data provide further evidence that low socio-economic status, oral contraceptive use and poor genital hygiene conditions were the main risk factors for cervical cancer. Recommendations: Scaling up of cervical cancer prevention and control interventions should address socio-economic, behavioural and HIV infection among the risk population.