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Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana
BACKGROUND: Cervical cancer is the leading cause of female cancer mortality in Botswana with the majority of cervical cancer patients presenting with late-stage disease. The identification of factors associated with late-stage disease could reduce the cervical cancer burden. This study aims to ident...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259023/ https://www.ncbi.nlm.nih.gov/pubmed/34229672 http://dx.doi.org/10.1186/s12905-021-01402-5 |
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author | Friebel-Klingner, Tara M. Luckett, Rebecca Bazzett-Matabele, Lisa Ralefala, Tlotlo B. Monare, Barati Nassali, Mercy Nkuba Ramogola-Masire, Doreen Bvochora, Memory Mitra, Nandita Wiebe, Douglas Rebbeck, Timothy R. McCarthy, Anne Marie Grover, Surbhi |
author_facet | Friebel-Klingner, Tara M. Luckett, Rebecca Bazzett-Matabele, Lisa Ralefala, Tlotlo B. Monare, Barati Nassali, Mercy Nkuba Ramogola-Masire, Doreen Bvochora, Memory Mitra, Nandita Wiebe, Douglas Rebbeck, Timothy R. McCarthy, Anne Marie Grover, Surbhi |
author_sort | Friebel-Klingner, Tara M. |
collection | PubMed |
description | BACKGROUND: Cervical cancer is the leading cause of female cancer mortality in Botswana with the majority of cervical cancer patients presenting with late-stage disease. The identification of factors associated with late-stage disease could reduce the cervical cancer burden. This study aims to identify potential patient level clinical and sociodemographic factors associated with a late-stage diagnosis of cervical cancer in Botswana in order to help inform future interventions at the community and individual levels to decrease cervical cancer morbidity and mortality. RESULTS: There were 984 women diagnosed with cervical cancer from January 2015 to March 2020 at two tertiary hospitals in Gaborone, Botswana. Four hundred forty women (44.7%) presented with late-stage cervical cancer, and 674 women (69.7%) were living with HIV. The mean age at diagnosis was 50.5 years. The association between late-stage (III/IV) cervical cancer at diagnosis and patient clinical and sociodemographic factors was evaluated using multivariable logistic regression with multiple imputation. Women who reported undergoing cervical cancer screening had lower odds of late-stage disease at diagnosis (OR: 0.63, 95% CI 0.47–0.84) compared to those who did not report screening. Women who had never been married had increased odds of late-stage disease at diagnosis (OR: 1.35, 95% CI 1.02–1.86) compared to women who had been married. Women with abnormal vaginal bleeding had higher odds of late-stage disease at diagnosis (OR: 2.32, 95% CI 1.70–3.16) compared to those without abnormal vaginal bleeding. HIV was not associated with a diagnosis of late-stage cervical cancer. Rural women who consulted a traditional healer had increased odds of late-stage disease at diagnosis compared to rural women who had never consulted a traditional healer (OR: 1.61, 95% CI 1.02–2.55). CONCLUSION: Increasing education and awareness among women, regardless of their HIV status, and among providers, including traditional healers, about the benefits of cervical cancer screening and about the importance of seeking prompt medical care for abnormal vaginal bleeding, while also developing support systems for unmarried women, may help reduce cervical cancer morbidity and mortality in Botswana. |
format | Online Article Text |
id | pubmed-8259023 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-82590232021-07-06 Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana Friebel-Klingner, Tara M. Luckett, Rebecca Bazzett-Matabele, Lisa Ralefala, Tlotlo B. Monare, Barati Nassali, Mercy Nkuba Ramogola-Masire, Doreen Bvochora, Memory Mitra, Nandita Wiebe, Douglas Rebbeck, Timothy R. McCarthy, Anne Marie Grover, Surbhi BMC Womens Health Research BACKGROUND: Cervical cancer is the leading cause of female cancer mortality in Botswana with the majority of cervical cancer patients presenting with late-stage disease. The identification of factors associated with late-stage disease could reduce the cervical cancer burden. This study aims to identify potential patient level clinical and sociodemographic factors associated with a late-stage diagnosis of cervical cancer in Botswana in order to help inform future interventions at the community and individual levels to decrease cervical cancer morbidity and mortality. RESULTS: There were 984 women diagnosed with cervical cancer from January 2015 to March 2020 at two tertiary hospitals in Gaborone, Botswana. Four hundred forty women (44.7%) presented with late-stage cervical cancer, and 674 women (69.7%) were living with HIV. The mean age at diagnosis was 50.5 years. The association between late-stage (III/IV) cervical cancer at diagnosis and patient clinical and sociodemographic factors was evaluated using multivariable logistic regression with multiple imputation. Women who reported undergoing cervical cancer screening had lower odds of late-stage disease at diagnosis (OR: 0.63, 95% CI 0.47–0.84) compared to those who did not report screening. Women who had never been married had increased odds of late-stage disease at diagnosis (OR: 1.35, 95% CI 1.02–1.86) compared to women who had been married. Women with abnormal vaginal bleeding had higher odds of late-stage disease at diagnosis (OR: 2.32, 95% CI 1.70–3.16) compared to those without abnormal vaginal bleeding. HIV was not associated with a diagnosis of late-stage cervical cancer. Rural women who consulted a traditional healer had increased odds of late-stage disease at diagnosis compared to rural women who had never consulted a traditional healer (OR: 1.61, 95% CI 1.02–2.55). CONCLUSION: Increasing education and awareness among women, regardless of their HIV status, and among providers, including traditional healers, about the benefits of cervical cancer screening and about the importance of seeking prompt medical care for abnormal vaginal bleeding, while also developing support systems for unmarried women, may help reduce cervical cancer morbidity and mortality in Botswana. BioMed Central 2021-07-06 /pmc/articles/PMC8259023/ /pubmed/34229672 http://dx.doi.org/10.1186/s12905-021-01402-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Friebel-Klingner, Tara M. Luckett, Rebecca Bazzett-Matabele, Lisa Ralefala, Tlotlo B. Monare, Barati Nassali, Mercy Nkuba Ramogola-Masire, Doreen Bvochora, Memory Mitra, Nandita Wiebe, Douglas Rebbeck, Timothy R. McCarthy, Anne Marie Grover, Surbhi Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana |
title | Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana |
title_full | Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana |
title_fullStr | Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana |
title_full_unstemmed | Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana |
title_short | Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana |
title_sort | clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in botswana |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259023/ https://www.ncbi.nlm.nih.gov/pubmed/34229672 http://dx.doi.org/10.1186/s12905-021-01402-5 |
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