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Cervical cancer screening in a rural population of Zimbabwe
1Salvation Army, Howard Hospital, Glendale, Zimbabwe.
Objective:
To review cervical cancer screening since its introduction to a rural district hospital in Zimbabwe.
Design:
Retrospective, descriptive.
Setting:
Rural district hospital.
Subjects:
Data from 419 cervical smears performed on women who had cervical cancer screening as part of a routine post partum visit from 1994 to 1996 was available for analysis.
Main Outcome Measure:
Rates of abnormal cervical smears.
Results:
The majority of the patients were of age 20 to 29 years (47.2%) and of low gravidity (Zero to three children) 62.6%). A total of 173 slides (41.3%) were normal. Of the abnormal smears, 158 (37%) had inflammation, and 65 cases (15.5%) demonstrated abnormal cytology of which 50 (12%) were low grade squamous epithelial lesions (atypia/CINI), and the remaining 15 (3.6%) high grade squamous intra-epithelial lesions (CIN II/III and carcinoma in situ).
Conclusion:
There was a high frequency of abnormal smears at this rural district hospital. Furthermore, there were problems in sampling the population at highest risk, shortages of supplies, technical problems in sampling and interpretation, and difficulties in follow up of patients. These problems are discussed including the confounding effect of the Human Immunodeficiency Virus.
