Epidemiology and Management of Precancerous Cervical Lesions in a Rural African Setting
Kouma Aminata,
Sissoko Abdoulaye,
Sima Mamadou,
Fané Seydou,
Dembélé Sounkalo,
Guindo Boubakary,
Bocoum Amadou,
Tiounkani THERA,
Tegueté Ibrahima,
Traoré Youssouf,
Mounkoro Nani
Introduction: Since 2010, a cervical cancer screening program has been implemented in the city of
Sikasso. To date, limited data are available regarding the epidemiology of cervical precancerous and
cancerous lesions in this setting. This study aimed to determine the prevalence of these lesions and to
identify associated risk factors.
Methods: We conducted a multicenter longitudinal study with retrospective data collection of cervical
cancer screening records in Sikasso from 2010 to 2017. Descriptive statistics were used to summarize
the data. Odds ratios (ORs) with 95% confidence intervals were calculated using logistic regression to
identify factors associated with precancerous and cancerous cervical lesions.
Results: The mean age of the participants was 37 years. The prevalence of precancerous and cancerous
lesions was 1.2% and 1.5%, respectively. These prevalences were higher among women living in rural
areas. The main factors associated with cervical lesions were advanced age, early age at menarche,
leukorrhea, and HIV infection. More than half of the women diagnosed with cervical cancer received
only palliative care.
Conclusion: The burden of cervical cancer lesions was higher among rural women compared to their
urban counterparts, with a substantial proportion receiving only palliative management. Advanced age,
early menarche, and HIV infection were the determinants of cervical lesions in this population. These
findings highlight the need to strengthen screening and early management strategies, particularly in
rural settings.
