[Precancerous lesions of the uterine cervix in Pointe-Noire, Congo]

The purpose of this study was to determine the cytological profile and risk factors for intraepithelial precancerous lesions of the uterine cervix in an urban community of Pointe-Noire, an industrialized seaport located in the southeast region of Congo-Brazzaville. A transverse study was carried out over a period of 18 months (January 2003 to July 2004) in the Center for the Study of Human and Animal Diseases (CSHAD) at the General Adolphe Sie Hospital in Pointe-Noire. A total of 1347 files of women benefiting from cervico-vaginal smears were included in the study. Testing was undertaken either at the request of the patient (voluntary screening) or at the request of a health care provider (physician, midwife or nurse) in relation with various gynecological problems. The relative frequency of intraepithelial lesions was estimated to be 15.36% including 9.17% of low-grade intraepithelial lesions (Ig IEL) and 6.19% of high-grade intraepithelial lesions (hg IEL). The mean age of patients with hg IEL was 42.25 years (range, 12 to 17). Study of the interval between actual age at the time of sample collection and age of first sexual relations showed that women presenting IEL had an interval of at least 20 years. This interval probably corresponds to the time necessary for the interaction between human papillomavirus (HPV) and epithelial cells of the uterine cervix to induce intraepithelial lesions that lead to development of cancer of the uterine cervix. Comparative analysis of the number of sexual partners between the group of women with normal smears and the group with smears showing hg IEL indicated a clear predominance of the mean number of partners in the latter group, i.e., 2 +/- 1,2 versus 5 +/- 1,8 (p < 0.05). Most IEL were observed in multigestational women who accounted for 75.39% with a mean of 6.21 for hg IEL. This preliminary study provides a sound factual basis in terms of epidemiological data on these precancerous lesions of the uterine cervix in the Kouilou department of Congo-Brazzaville. These data will serve as benchmarks and guidance for forthcoming screening campaigns for early detection of uterine cervix cancer.