Cervical cancer screening in a referral setting study done at CHUK 2015.

Abstract

Objective: The objective of our study is to describe social demographic, motivations, clinical characteristics and outcome of patients consulting for cervical cancer screening service at a tertiary care setting in Rwanda Methods: Our study is a cross-sectional prospective study carried out over 6 months (September 2015-February 2016) at Kigali University Teaching Hospital (CHUK) which is the largest referral facility in Rwanda. Knowledge, perceptions and cues for action associated with self-reported cervical screening uptake were explored. Our study population (n = 150), was obtained from women of child-bearing age onwards consulting for screening services at CHUK. Data on socio-demographic status (age, level of education, marital status, occupation) sexual and reproductive health knowledge on cervical cancer and susceptibility to the disease were collected using self-administered semi-structured questionnaires. Results: In total 150 women were screened during the six months study period. All provinces in Rwanda were represented, with Kigali leading with 54% of all women screened. The average age was 43.51 years. Only 20(13.3%) of women coming in for screening were self reported while 130 were referred by health professionals from lower health facility countrywide. Forty-nine (32.7%)women presenting for screening had not had a speculum exam done to evaluate the cervix. Visual inspection with ascetic acid (VIA) followed by colposcopy were the screening methods available at CHUK with 22(14.7%)women being VIA positive 8(5.3%) with suspected cancer, while 120 (80%) were found to be VIA negative, .Histological distribution among women who had biopsy taken was six cases of CIN 1, four cases of CIN 2, two cases of CIN 3 and eight confirmed cancer. Conclusion: CHUK receives cases countrywide, with the majority of them being referrals from lower health facility levels. Few patients self report in for screening services available at CHUK. Among women presenting for screeing and biopsied, a large number (40%) were found to already have cervical cancer.. Increasing knowledge about available services and the need for voluntary cervical cancer screening is a key element to improving cervical cancer care and outcomes in Rwanda.