Cervical cancer screening in Ghana, west Africa: prevalence of abnormal cytology and challenges for expanding screening.
Aims were to assess the prevalence of Papanicolaou (Pap) abnormalities found with cervical cancer screening in Agogo and Nkawie, communities in the Ashanti region of Ghana, and compare the correlation between Pap readings performed at the Komfo Anokye Teaching Hospital in Kumasi, Ghana, and at the Mayo Clinic cytology laboratory in Rochester, MN. Demographic data was collected and Pap tests were performed on women recruited for screening in the communities of Agogo (n=119) and Nkawie (n=255). The Pap tests were assessed by pathology laboratory staff at Komfo Anokye Teaching Hospital and Mayo Clinic. There was a significant difference in prevalence of abnormal cytology between the sites with a rate of 12.6% in Agogo and 3.5% in Nkawie (P=0.016). Demographic differences were noted in education level (P<0.001), occupation (P<0.001), religion (P=0.002), and marital status (P<0.001). The Cohen correlation coefficient between the two pathology departments interpreting samples was 0.185, which indicates a significant degree of discordance (P<0.001). Currently Ghana does not have a national cervical cancer screening program. Identifying higher risk communities and patients as a priority for screening may be useful with limited resources. Accurate identification of Pap abnormalities is necessary to implement an effective screening program.
Mayo Clinic College of Medicine (K.S.H., R.J.M., L.E.R., N.P.N., M.J.B., A.C., L.R., K.M.) Rochester, Minnesota Departments of Pathology (S.Q., O.O.-A., E.A.) Obstetrics/Gynecology (F.A.), Komfo Anokye Teaching Hospital Kwame Nkrumah University of Science and Technology (F.A., D.A.), Kumasi, Ghana.
Kathryn S
KS
Handlogten
Rochelle J
RJ
Molitor
Lindsey E
LE
Roeker
Nirmala P
NP
Narla
Maria J
MJ
Bachman
Solomon
S
Quayson
Osei
O
Owusu-Afriyie
Ernest
E
Adjei
Frank
F
Ankobea
Amy
A
Clayton
Lewis
L
Roberts
Kathy
K
MacLaughlin
Daniel
D
Ansong
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005869:Ghana; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology*; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D055815:Young Adult