title: Risk Factors Associated with Invasive Cervical Carcinoma among Women Attending Jimma University Specialized Hospital, Southwest Ethiopia: A Case Control Study.
abstract: BACKGROUND
  Cervical cancer is a more serious public health problem than other cancers in women in Sub-Saharan Africa in general and in Ethiopia in particular. Thus, this study assessed risk factors related to invasive cervical carcinomas in southwestern Ethiopia.
  
  
  METHODS
  Unmatched case control study was conducted in Jimma University Specialized Hospital from April 1 to September 30, 2010. The study consisted of 60 cases (women who had cervical cancers based on histopathologic examination) and 120 controls (women with no cervical cancers). Semi-structured questionnaire was utilized for data collection. Vaginal examinations often visualized with speculum insertions were done for both cases and controls. Punch cervical biopsies were then performed for the suspected cases at Jimma University Hospital that serves about 15 million people in a catchment radius of 250 kms. Data were analyzed using SPSS version 13.0 software. Univariate and multivariate analyes were done to describe and identify independent predictors of cervical cancer.
  
  
  RESULTS
  The mean ages of cases and controls were 47.7 (SD=10.8) and 35.5 (SD =10.5) years respectively. Older women (40-59 years), (OR= 4.7; 95%CI= 2.3-9.6), more than one husband (OR= 2.0; 95%CI=1.0-3.9), as well as more than one wife in lifetime, (OR= 3.0; 95% CI= 1.5-5.9), women who had more than 4 children, (OR =10.3, 95% CI= 3.6-29.0), and age greater than 25 years at first full term delivery, (OR= 8.8; 95% CI= 3.5-22.0) were statistically significant and the latter two were independently associated with invasive cervical cancer. Only 7(11.7 %) of cases and 58(48.3%) of controls ever heard of cervical cancers; however, 2(3.3%) of cases and 7(5.8%) of controls had ever had history of papaneocolous (pap) smear tests done.
  
  
  CONCLUSIONS
  Poor knowledge on cervical cancer was observed that required more work to be done to increase knowledge of mothers on cervical cancer and on associated risk factors. Behavioral communication activities and establishment of cervical cancer screening programs for the young could help reduce the advancement of cervical cancer particularly among the less knowledgeable, older and grand multiparous women in our parts of the world.
authors.affiliation: Department of Medical laboratory Sciences and Pathology, Jimma University, Ethiopia.
authors.forename: Mesele
authors.initials: M
authors.lastname: Bezabih
authors.affiliation: Department of Epidemiology and Biostatistics, Jimma University, Ethiopia.
authors.forename: Fasil
authors.initials: F
authors.lastname: Tessema
authors.affiliation: Department of Obstetrics and Gynecology, Jimma University, Ethiopia.
authors.forename: Hailemariam
authors.initials: H
authors.lastname: Sengi
authors.affiliation: Department of Epidemiology and Biostatistics, Jimma University, Ethiopia.
authors.forename: Amare
authors.initials: A
authors.lastname: Deribew
mesh_terms: D000328:Adult; D000367:Age Factors; D001364:Awareness; D016022:Case-Control Studies; D005002:Ethiopia; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D008403:Mass Screening; D008423:Maternal Age; D008875:Middle Aged; D016017:Odds Ratio; D010298:Parity; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D014626:Vaginal Smears
keywords: Jimma; invasive cervical carcinoma; risk factors; south west Ethiopia