Dynamics of Factors Responsible for the Resurgence of Cervical Cancer Lesions in Women in Developing Countries

Abstract

Cervical cancer is a major public health problem worldwide and it remains one of the most common malignancies of women. The purpose was to determine, factors responsible for the upsurge of the uterine cells lesions observed on cervical smear abnormalities among Cameroonian women. To achieve our goals, the current study was carried out in three regions of Cameroon: South, Far North and Center Region for a period of two years. It was a cross sectional and descriptive study. Analyses of samples collected were performed at the biological laboratory of each hospital. All women aged 18 to 65, with sexually active were included in our study. Principal techniques used were the conventional Papanicolau staining method. The Sample size was made up of 1443 women, among these; 43 had unsatisfactory profiles and 1400 satisfactory profile with a median age of the study population being 35.33 ± 7.1. Microscopy analyses showed some microorganisms such as Trichomonas vaginalis; Candida albicans; Gardnerella Vaginalis and Aspergillus. Abnormalities were distributed as follow; NIL/M (71%), ASCUS (9.7%), ASGUS (10.2%), LSIL (6.8%), HSIL (2.3%). The most representative age group was [30-35] (24.7%)(P value=0.02). A high percentage was observed among polygamous group. Microscopy smears presented some koilocytes cells presenting binucleation as observed. Analyses of first early intercourse (r2=0.3), showed the lack of correlation with appearance of lesions; the same observation was done with number of pregnancy (r2=0.4). The use of intra uterine device (IUD) (r2=0.9) and injections (r2=0.9), as contraceptive methods showed correlation between cervical lesions, as well as the number of sexual partners (r2=0.98). The last significant analyses was observed by comparing appearance of lesions and drug habits especially alcoholism (r2=0.9) and nicotinism (r2=0.91). Microbial infections showed a correlated data between infections by Trichomonas Vaginalis (P value= 0.003) and Herpes Simplex Virus (r2=0.8); these observations places these infections as risk factors involved in the upsurge of precancerous lesions. At the end of this study, we can conclude that the number of pregnancies and sexual partners; the use of IUD  and injections as contraceptive method and the consumption of alcohol and tobacco are risks factors identified during this study able to enhance the upsurge of precancerous lesions; to these we can add microbial infections.