Factors associated with tumour stage at presentation in invasive cervical cancer.
OBJECTIVE
The main objective of the study was to determine the demographic, social, clinical, laboratory and histologic factors associated with late stage presentation in cervical cancer.


METHODS
A cross sectional study.


METHODS
Government tertiary referral institutions, Harare, Zimbabwe


METHODS
One hundred consecutive cases of histology proven cervical cancer that presented for treatment between November 2001 and April 2002.


METHODS
The patients were categorized as early invasive cancer (stage I and II) and late invasive cancer (stage III and IV).


RESULTS
The median age of the patients was 48 years (Q1=39 and Q3= 60). Eighty percent presented with late stage disease. Squamous cell carcinoma was the commonest histology (96%) with adenocarcinoma constituting only 4% of all tumours. Poorly differentiated tumour histology and no history of prior cervical cancer screening were found to be significantly associated with late tumour stage at presentation. The odds of presenting with late stage disease in women with a poorly differentiated tumour were 12.97 (95% CI 2.03 to 82.55; p = .007), whilst the odds of late stage presentation in the absence of a history of screening were 11.13 (95% CI 1.33 to 93.21; p = .026).


CONCLUSIONS
Intrinsic tumour characteristics were the most important in this population in determining late stage at diagnosis and the value of screening was also highlighted by the results. The odds ratios had wide 95% confidence intervals, thus limiting their usefulness as point estimates.
Department of Radiology, School of Medicine, University of Zimbabwe, Avondale Harare, Zimbabwe.
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N
Ndlovu
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Kambarami
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology / Q000523:psychology; D017677:Age Distribution; D000367:Age Factors; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000523:psychology; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D016015:Logistic Models; D017533:Marital Status / Q000706:statistics & numerical data; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology* / Q000523:psychology; D015030:Zimbabwe / Q000453:epidemiology