title: A review of cervical cancer patients presenting in Harare and Parirenyatwa Hospitals in 1998.
abstract: OBJECTIVE
  To document the socio-demographic profile, presenting symptoms, disease stage and treatment modality offered to all women attending Harare and Parirenyatwa Hospitals with a histological diagnosis of invasive cervical cancer in 1998.
  
  
  METHODS
  A cross sectional study.
  
  
  METHODS
  Parirenyatwa Hospital and Harare Central Hospital.
  
  
  METHODS
  All women with a histological diagnosis of cervical cancer admitted between 11 January 1998 and 14 December 1998 were recruited into the study.
  
  
  RESULTS
  A total of 196 patients, with a median age of 47 years (range 24 to 80 years) were recruited into the study. A high proportion (63.3%) of the women were from rural areas. The mean age at first pregnancy was 17.9 years (SD 2.8) and 112 (63.3%) first sought treatment at the primary health care centre. Persistent vaginal discharge was the most frequent (69.4%) presenting complaint. One hundred and ninety five patients (99.5%) had histological confirmation of invasive cervical cancer (91.8% squamous cell carcinoma, 7.7% adenocarcinoma). Clinical staging by The International Federation of Gynaecology and Obstetrics (FIGO) classification confirmed that the majority (80.3%) of the cancers had spread from the cervix into the parametrium and beyond (stage 2b and above) at the time of presentation. Radiation therapy was the most commonly used (77.0%) treatment modality.
  
  
  CONCLUSIONS
  This study demonstrates that the burden of cervical cancer occurs around the peak age of 47 years and that the majority of women present with advanced disease. None of the women had ever been screened for cervical cancer. The planned introduction of a cervical cancer screening programme by visual inspection of the cervix with acetic acid (VIA), together with a health education campaign may result in a shift towards more women presenting with early curable cervical cancer cases.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Zimbabwe, Medical School, P O Box A178, Avondale, Harare, Zimbabwe.
authors.forename: Z M
authors.initials: ZM
authors.lastname: Chirenje
authors.forename: S
authors.initials: S
authors.lastname: Rusakaniko
authors.forename: V
authors.initials: V
authors.lastname: Akino
authors.forename: M
authors.initials: M
authors.lastname: Mlingo
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006266:Health Education; D006760:Hospitalization / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D020380:Needs Assessment; D009367:Neoplasm Staging; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D014600:Utilization Review; D015030:Zimbabwe / Q000453:epidemiology