Prevalence and Determinants of Precancerous Lesions in HPV-DNA Positive Women in the Population Solutions for Health Cervical Cancer Screening Program in Zimbabwe

Abstract

Globally cervical cancer is the most common neoplastic disease affecting women and second only to breast cancer. In Zimbabwe cervical cancer is the most leading common cancer among black women. Cervical cancer screening in Zimbabwe is opportunistic and cervical cancer remains a considerable health problem with a high proportion of diagnoses in advanced stages. It has become imperative to enhance cervical cancer screening services to reduce cervical cancer related morbidity and mortality as well as other negative consequences to the families and communities. Despite the high incidence of cervical cancer reported in Zimbabwe, populationbased studies on the HPV prevalence and correlates distribution are scarce. No information is available on cervical cancer precancerous lesion prevalence among women who test positive for HPV DNA. It is against this background that the researcher is carrying out this study aimed at determining the prevalence and determinants of HPV-DNA positive results in Zimbabwe. The significance of this study was centred on improving treatment outcomes of HPV DNA positive women, as well as helping program managers to identify gaps and mitigate the gaps in the cervical cancer screening program. The scope of the study was delimited to a sample of 385 HPV-DNA positive women who had VIAC done and were selected from the Population Solutions for Health’s seven sites database. This is quantitative research which utilised an analytical cross-sectional study and data was entered into Epi info 7 and analysed using STATA version 13. The prevalence of cervical cancer precancerous lesions among HPV positive women was 28.31%. Demographic characteristics which included level of education and employment status were found to be not associated with precancerous cervical lesions [COR: 1.1 (95%CI: 0.9-1.5); p=0.159]. Women who indicated that they used condoms were 1.7 times more likely to have precancerous cervical lesions [COR: 1.7 (95% CI: 1.1-2.8); p=0.022]. This study found that women who were HIV positive and on treatment were 51% less likely to be treated for precancerous cervical lesions [COR: 0.5 (95%CI: 0.3-0.8); p=0.003]. Age at first sexual debut at 18 years was found to be statistically significant at 12% reduced odds of precancerous cervical lesions [COR: 0.9 (95%CI: 0.8-1.0); p=0.010]. Women aged above 40years were 2.8 times more likely to have precancerous lesions. History of STI has a significant contribution to cervical cancer. Screening of HIV positive women for cervical cancer is independently associated with reduced odds of cervical cancer.