Cancer of the Uterine Cervix at the University of Calabar Teaching Hospital, Calabar Nigeria

Abstract

Background: This study was carried out to highlight the prevalence of cancer of the uterine cervix and shortcoming in the management of cervical cancer in our hospital. There is the need to improve on our personnel training and equipment acquisition. Methods: This was a retrospective study. Case folders of forty-seven patients who were diagnosed with cancer of the cervix were retrieved and reviewed. Information on age, parity, clinical presentation, stages of the disease and management as well as management problems were analyzed. Data were analyzed using tables showing figures and simple percentages and arithmetic mean was used to depict the mean age that patients present with the disease. Results: There were 1,450 gynaecological admissions during the study. Forty patients had histologically confirmed cancer of the cervix. This gave a prevalence of 2.76% of gynaecological admissions in this center. Majority of the women (52.5%) were aged 40-59 years. The youngest patient in the study was aged 30 years. The mean age at diagnosis was 51.5 years. Vaginal bleeding and offensive vaginal discharge was present in 85.5% and 80.0% of patents respectively. The lesions were commonly exophytic/hard, or fungating and friable in 77.5% of cases. 82.5% presented with late stage disease where little or nothing could be done for them. Twelve patients (30.0%) had total abdominal hysterectomy. This was done for stages 1 and II diseases. Two (16.7%) had vault recurrence. Fifty-five percent of the patients had referrals for radiotherapy. Three patients (13.6%) died in the ward after discharge. Conclusions: Cancer of the uterine cervix is still a problem in our setting where uptake of screening methods and the availability of cytopathologists are still dismally low. There is the clear need for training in gynecologic oncology especially in the area of radical surgeries and use of current therapeutic options in the care of these patients.