Details
Category: Volume 10 Issue 07 July 2022
Hits: 482

Title: Histopathological Features in Development of Cancer of the cervix in relation to Sexually Transmitted Infections among Sexually active women attending Machakos Cancer Care and Research Centre

Authors: Munyoki Nyamai, Antony Irungu

 DOI: https://dx.doi.org/10.18535/jmscr/v10i7.12

Abstract

Background: Sexually transmitted infections (STIs) diagnosis, treatment and management programmes have existed for many decades worldwide. Cancer of cervix diagnosis, treatment and management is however a newer phenomenon compared to STIs. Globally, it is estimated that 568,847 women in their reproductive age are diagnosed with cancer of the cervix and an estimated 311,365 deaths occur annually. Concurrently 499 million cases of STIs occur annually. This high burden of the infections if intervention measures are not put in place, the cases may increase into many folds in the coming future.

Objective: This study sought to investigate the influence of STIs in the histopathological outcomes among sexually active women attending Machakos Cancer Care and Research Centre.

Methods: The study design applied cross-sectional design to achieve this objective. It involved women who were sexually active and consented to the study voluntarily. The study involved STIs testing and histopathology analysis.

Result: The total number of participants who consented to the study after being informed about the consequences and the importance of the research were one hundred and seventy-six. The mean age of the participants was 40.6 years, a median of 43 and a range of 22-58 years. In overall 55 % of the participants had positive STIs outcomes while 44 % of the same population had an abnormal cervical histopathology outcome. The majority of the abnormal histopathology outcomes were among women aged 40 years and above. STIs were distributed in all ages. HPV and HIV were pathogen of interest because their influence was statistically significant.

Conclusion: This current study has revealed that STIs infections are very important agents of interest in establishment and progression of cancer of the cervix within the cervical walls of the sexually active women. HPV and HIV were highest influencers of histopathological outcomes in this study.

Keywords: Cancer of the Cervix, Cervical Intraepithelial Neoplasia, Histopathology, Human Immunodeficiency Syndrome (HIV), Human papillomavirus (HPV), Sexually Transmitted Infections (STIs).

References

  1. Slattery ML, OVERALL Jr JC, ABBOTT TM, French TK, Robinson LM, Gardner J. Sexual activity, contraception, genital infections, and cervical cancer: support for a sexually transmitted disease hypothesis. American Journal of Epidemiology. 1989 Aug 1;130(2):248-58.
  2. Temmerman, M., Kidula, N., Tyndall, M., Rukaria-Kaumbutho, R., Muchiri, L. and Ndinya-Achola, J.O., 1998. The supermarket for women's reproductive health: the burden of genital infections in a family planning clinic in Nairobi, Kenya. Sexually transmitted infections, 74(3), pp.202-204.
  3. Zur Hausen H. Papillomaviruses and cancer: from basic studies to clinical application. Nature reviews cancer. 2002 May;2(5):342-50.
  4. Camporiondo MP, Farchi F, Ciccozzi M, Denaro A, Gallone D, Maracchioni F, Favalli C, Ciotti M. Detection of HPV and co-infecting pathogens in healthy Italian women by multiplex real-time PCR. Le infezioni in medicina. 2016 Jan 1;24(1):12-7.
  5. Dai Zhang TL, Chen L, Zhang X, Zhao G, Liu Z. Epidemiological investigation of the relationship between common lower genital tract infections and high-risk human papillomavirus infections among women in Beijing, China. 2017;12(5).
  6. Mirambo MM, Aboud S, Mushi MF, Seugendo M, Majigo M, Groß U, et al. Serological evidence of acute rubella infection among under-fives in Mwanza: a threat to increasing rates of congenital rubella syndrome in Tanzania. Ital J Pediatr. 2016;42(1):54.
  7. Njagi SK, Mugo NR, Reid AJ, Satyanarayana S, Tayler-Smith K, Kizito W, et al. Prevalence and incidence of cervical intra-epithelial neoplasia among female sex workers in Korogocho, Kenya. Public Health Action. 2013;3(4):271–275.
  8. Melnikow J, Nuovo J, Willan AR, Chan BK, Howell LP. Natural history of cervical squamous intraepithelial lesions: a meta-analysis. Obstetrics & Gynecology. 1998 Oct 1;92(4):727-35.
  9. World Medical Association. WMA declaration of Helsinki: Ethical principles for medical research involving human subjects [Internet]. Ferney-Voltaire, FR: Author; 2013.
  10. Holowaty P, Miller AB, Rohan T, To T. Natural history of dysplasia of the uterine cervix. Journal of the National Cancer Institute. 1999 Feb 3;91(3):252-8.
  11. Kiviat NB, Koutsky LA. Specific human papillomavirus types as the causal agents of most cervical intraepithelial neoplasia: implications for current views and treatment.
  12. American College of Obstetricians and Gynecologists. Practice bulletin no. 157: cervical cancer screening and prevention. Obstet Gynecol. 2016;127(1):e1-20.
  13. Anastos K, Hoover DR, Burk RD, Cajigas A, Shi Q, Singh DK, Cohen MH, Mutimura E, Sturgis C, Banzhaf WC, Castle PE. Risk factors for cervical precancer and cancer in HIV-infected, HPV-positive Rwandan women. PLoS One. 2010;5(10).
  14. Varughese J, Richman S. Cancer care inequity for women in resource-poor countries. Reviews in Obstetrics and Gynecology. 2010;3(3):122.
  15. Muitta E, Were T, Kebira AN. Reproductive and Lifestyle Characteristics in Kenyan Women Presenting With Precancerous Cervical Lesions. EA Health Research Journal. 2019 Nov 29;3(2):116-24.
  16. Lomalisa P, Smith T, Guidozzi F. Human immunodeficiency virus infection and invasive cervical cancer in South Africa. Gynecologic Oncology. 2000 Jun 1;77(3):460-3.
  17. Madeleine MM, Anttila T, Schwartz SM, Saikku P, Leinonen M, Carter JJ, Wurscher M, Johnson LG, Galloway DA, Daling JR. Risk of cervical cancer associated with Chlamydia trachomatis antibodies by histology, HPV type and HPV cofactors. International journal of cancer. 2007 Feb 1;120(3):650-5.
  18. Vielot N, Hudgens MG, Mugo N, Chitwa M, Kimani J, Smith J. The role of chlamydia trachomatis in high-risk human papillomavirus persistence among female sex workers in Nairobi, Kenya. Sexually transmitted diseases. 2015 Jun;42(6):305.
  19. Biernat-Sudolska M, Szostek S, Rojek-Zakrzewska D, Klimek M, Kosz-Vnenchak M. Concomitant infections with human papillomavirus and various mycoplasma and ureaplsasma species in women with abnormal cervical cytology. Advances in medical sciences. 2011 Dec 1;56(2):299-303.
  20. De Sanjose S, Munoz N, Bosch FX, Reimann K, Pedersen NS, Orfila J, Ascunce N, Gonzalez LC, Tafur L, Gili M, Lette I. Sexually transmitted agents and cervical neoplasia in Colombia and Spain. International journal of cancer. 1994 Feb 1;56(3):358-63.

Corresponding Author

Munyoki Nyamai

Department of Medical Laboratory Sciences, Masinde Muliro University of Science and Technology, P. O. Box 190-50100, Kakamega, Kenya