Cervical Cancer in Women Admitted at University Hospital Agostinho Neto, Cape Verde, from 2016-2020: A Cross-Sectional Study
DOI:
https://doi.org/10.34635/rpc.1068Keywords:
Cabo Verde, Delivery of Health Care, Hospitalization, Human Papillomavirus Viruses, Uterine Cervical NeoplasmsAbstract
Introduction: Cervical cancer is the leading cause of cancer death among women in Cape Verde. Advanced-stage disease is often the initial diagnosis. This study aimed to characterize the profile of women with cervical cancer admitted to a referral hospital in Cape Verde.Methods: This was a cross-sectional study. The clinical files of the first admission of 104 women with cervical cancer admitted to the Agostinho Neto University Hospital (HUAN) between January 2016 and December 2020 were reviewed. Descriptive statistics were used to analyze the data.
Results: At admission, the women’s ages ranged from 26 to 89 and approximately 47.3% of them had a low level of education. Most of the women lived on the island of Santiago (75%) and were not employed (75%). Vaginal bleeding was the main symptom reported (72.7%) and stage I disease was only observed in 28% of cases at the time of diagnosis. Squamous cell carcinoma was the most frequent histological type (67.7%) and chemotherapy was the most prescribed treatment (73.9%). The median length of stay at HUAN was 24 days and the main discharge outcome was evacuation to health centers outside the country (36.7%).
Conclusion: Enhancing women’s awareness and knowledge about cervical cancer, reducing barriers to screening and implementing strategies for timely diagnosis are critical steps in reducing the burden of the disease in Cape Verde.
Downloads
References
1. Cervical cancer [Internet]. [cited 2024 May 11]. Available from: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
2. Okunade KS. Human papillomavirus and cervical cancer. J Obstet Gynaecol J Inst Obstet Gynaecol. 2020 Jul;40(5):602–8.
3. Atnafu DD, Khatri R, Assefa Y. Drivers of cervical cancer prevention and management in sub-Saharan Africa: a qualitative synthesis of mixed studies. Health Res Policy Syst [Internet]. 2024 Feb 8 [cited 2024 May 8];22(1):21. Available from: https://doi.org/10.1186/s12961-023-01094-3
4. Olusola P, Banerjee HN, Philley JV, Dasgupta S. Human Papilloma Virus-Associated Cervical Cancer and Health Disparities. Cells. 2019 Jun 21;8(6):622.
5. WHO. Global strategy to accelerate the elimination of cervical cancer as a public health problem [Internet]. 2020 [cited 2024 May 6]. Available from: https://www.who.int/publications-detail-redirect/9789240014107
6. Bruni L, Serrano B, Roura E, Alemany L, Cowan M, Herrero R, et al. Cervical cancer screening programmes and age-specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis. Lancet Glob Health. 2022 Aug;10(8):e1115–27.
7. Jedy-Agba E, Joko WY, Liu B, Buziba NG, Borok M, Korir A, et al. Trends in cervical cancer incidence in sub-Saharan Africa. Br J Cancer [Internet]. 2020 Jul [cited 2024 May 11];123(1):148–54. Available from: https://www.nature.com/articles/s41416-020-0831-9
8. Federal Democratic Republic of Ethiopia Ministry of Health. Guideline for Cervical Cancer Prevention and Control in Ethiopia [Internet]. 2015. Available from: https://iccp-portal.org/map
9. World Bank [Internet]. [cited 2024 Jun 22]. The World Bank in Cabo Verde. Available from: https://www.worldbank.org/en/country/caboverde/overview
10. Resultados preliminares do V recenseamento geral da população e habitação - RGPH 2021 [Internet]. INE. [cited 2024 Jun 26]. Available from: https://ine.cv/publicacoes/resultados-preliminares-do-v-recenseamento-geral-da-populacao-habitacao-rgph-2021/
11. World Bank Group. Republic of Cabo Verde: Adjusting the Development Model to Revive Growth and Strengthen Social Inclusion. Systematic Country Diagnostic. [Internet]. Washington, DC; 2018. Available from: http://hdl.handle.net/10986/30550
12. World Bank Country and Lending Groups – World Bank Data Help Desk [Internet]. [cited 2024 Jun 22]. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups
13. Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. [Internet]. 2024 [cited 2024 May 8]. Available from: https://gco.iarc.who.int/today/en/fact-sheets-populations#countries
14. Veiga C. Cabo Verde diminuiu em 30% as evacuações para o exterior por doenças oncológicas - Ministério da Saúde [Internet]. 2023 [cited 2024 Jun 22]. Available from: https://minsaude.gov.cv/noticias/cabo-verde-diminuiu-em-30-as-evacuacoes-para-o-exterior-por-doencas-oncologicas/, https://minsaude.gov.cv/noticias/cabo-verde-diminuiu-em-30-as-evacuacoes-para-o-exterior-por-doencas-oncologicas/
15. Vilares AT, Ciabattoni R, Cunha TM, Félix A. Cervical cancer in Cape Verde: reappraisal upon referral to a tertiary cancer centre. ecancermedicalscience [Internet]. 2022 Nov 17 [cited 2024 May 6];16. Available from: https://ecancer.org/en/journal/article/1471-cervical-cancer-in-cape-verde-reappraisal-upon-referral-to-a-tertiary-cancer-centre
16. Rocha NSS, Clara BM, Luz LMM, do Rosário Oliveira Martins M. Knowledge, attitudes and practices of cervical cancer screening among female students enrolled in higher education institutions in Cabo Verde. ecancermedicalscience [Internet]. 2024 Mar 28 [cited 2024 Jun 23];18:1689. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984840/
17. Vieira R, Montezuma D, Barbosa C, Macedo Pinto I. Cervical cytology and HPV distribution in Cape Verde: A snapshot of a country taken during its first HPV nation-wide vaccination campaign. Tumour Virus Res. 2024 Jun;17:200280.
18. ICO/IARC HPV Information Centre, Cabo Verde - human papillomavirus and related cancers, fact sheet 2023. HPV INFORMATION CENTRE [Internet]. 2023 [cited 2024 May 11]. Available from: https://hpvcentre.net/datastatistics.php
19. Cervical cancer Cabo Verde 2021 country profile [Internet]. [cited 2024 Jun 23]. Available from: https://www.who.int/publications/m/item/cervical-cancer-cpv-country-profile-2021
20. Bruni L, Albero G, Serrano B, Mena M, Collado JJ, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases Report in the World. Summary Report 10 March 2023. [cited 2024 May 9].
21. Hospital Universitário Agostinho Neto. Departamento de Estatística. Dados Citologia 2018 a 2023. 2024.
22. HAN - Hospital Dr. Agostinho Neto [Internet]. [cited 2024 May 9]. Hospital Dr. Agostinho Neto. Available from: https://www.han.gov.cv/index.php/institucional/instituicao
23. WHO | Regional Office for Africa [Internet]. 2024 [cited 2024 May 8]. WHO AFRO Investment Case Series: Accelerating Cervical Cancer Elimination in Africa through Strengthened HPV Vaccination, Screening and Treatment. Available from: https://www.afro.who.int/publications/who-afro-investment-case-series-accelerating-cervical-cancer-elimination-africa
24. WHO. Comprehensive cervical cancer control. A guide to essential practice - Second edition [Internet]. [cited 2024 May 11]. Available from: https://www.who.int/publications-detail-redirect/9789241548953
25. Ludmilde Pina. Programa de rastreio do cancro do colo do útero [Internet]. 2016 Aug 8; Encontro de trabalho do Ministério da Saúde e Segurança social. Cidade Velha, Cabo Verde. Available from: https://minsaude.gov.cv/wpfd_file/ludmildepinacancro-do-colo-do-utero/
26. Ministério da Saúde. Manual de Prevenção e Controlo de Doenças Oncológicas. 2015.
27. Segundo Inquérito Nacional sobre os Fatores de Risco das Doenças Não Transmissíveis (IDNT II) [Internet]. 2021 [cited 2024 May 6]. Available from: https://www.afro.who.int/pt/countries/cabo-verde/publication/segundo-inquerito-nacional-sobre-os-fatores-de-risco-das-doencas-nao-transmissiveis-idnt-ii
28. Moreno M.J.C. PERFIL DAS MULHERES COM CÂNCER DE COLO DE ÚTERO USUÁRIAS DO HOSPITAL AGOSTINHO NETO – CABO VERDE [Internet] [Master thesis]. Universidade Federal de Santa Catarina; 2010. Available from: https://repositorio.ufsc.br/handle/123456789/93602
29. Instituto Nacional de Estatística (INE), Ministério da Saúde e da Segurança Social, e Utica International. 2020. Inquérito Demográfico e de Saúde Reprodutiva, IDSR-III, Cabo Verde 2018. Praia, Cabo Verde e Columbia, Maryland, USA. [Internet]. Available from: https://ine.cv/publicacoes/inquerito-demografico-saude-reprodutiva-isdr-iii-2018/
30. Anuário Estatístico de Cabo Verde – 2020 [Internet]. INE. [cited 2024 Jun 25]. Available from: https://ine.cv/publicacoes/anuario-estatistico-de-cabo-verde-2020/
31. Gebreegziabher ZA, Semagn BE, Kifelew Y, Abebaw WA, Tilahun WM. Cervical cancer screening and its associated factors among women of reproductive age in Kenya: further analysis of Kenyan demographic and health survey 2022. BMC Public Health [Internet]. 2024 Mar 8 [cited 2024 May 29];24(1):741. Available from: https://doi.org/10.1186/s12889-024-18148-y
32. Olubodun T, Balogun MR, Odeyemi AK, Odukoya OO, Ogunyemi AO, Kanma-Okafor OJ, et al. Barriers and recommendations for a cervical cancer screening program among women in low-resource settings in Lagos Nigeria: a qualitative study. BMC Public Health [Internet]. 2022 Oct 12 [cited 2024 May 29];22:1906. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9560022/
33. Petersen Z, Jaca A, Ginindza TG, Maseko G, Takatshana S, Ndlovu P, et al. Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Womens Health [Internet]. 2022 Dec 2 [cited 2024 May 29];22:486. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716693/
34. A AA, Birhanu Z, Godesso A. Health Literacy Among Young People in Africa: Evidence Synthesis. Risk Manag Healthc Policy [Internet]. 2023 [cited 2024 Jun 22];16:425. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042212/
35. Cristofori E, Zeffiro V, Alvaro R, D’Agostino F, Zega M, Cocchieri A. Health Literacy in Patients’ Clinical Records of Hospital Settings: A Systematic Review. SAGE Open Nurs [Internet]. 2022 Mar 7 [cited 2024 Jun 22];8:23779608221078555. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905211/
36. Singh H, Kolschen J, Samkange-Zeeb F, Brand T, Zeeb H, Schüz B. Modifiable predictors of health literacy in working-age adults - a rapid review and meta-analysis. BMC Public Health [Internet]. 2022 Jul 30 [cited 2024 Jun 22];22:1450. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9338662/
37. WHO report on cancer: setting priorities, investing wisely and providing care for all [Internet]. [cited 2024 Jun 22]. Available from: https://www.who.int/publications/i/item/9789240001299
38. Comité Regional para a África 71. Quadro de implementação da estratégia mundial para acelerar a eliminação do cancro do colo do útero enquanto problema de saúde pública na região africana da OMS : relatório do Secretariado [Internet]. Organização Mundial da Saúde. Escritório Regional para a África; 2021 [cited 2024 Jun 22]. Report No.: AFR/RC71/9. Available from: https://iris.who.int/handle/10665/348747
39. O’Donovan B, Mooney T, Rimmer B, Fitzpatrick P, Flannelly G, Doherty L, et al. Advancing understanding of influences on cervical screening (non)‐participation among younger and older women: A qualitative study using the theoretical domains framework and the COM‐B model. Health Expect Int J Public Particip Health Care Health Policy [Internet]. 2021 Dec [cited 2024 May 10];24(6):2023–35. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628586/
40. Muwonge R, Ngo Mbus L, Ngoma T, Gombe Mbalawa C, Dolo A, Da Ganda Manuel M, et al. Socio-demographic and reproductive determinants of cervical neoplasia in seven sub-Sahara African countries. Cancer Causes Control [Internet]. 2016 Dec [cited 2024 Jun 23];27(12):1437–46. Available from: http://link.springer.com/10.1007/s10552-016-0823-5
41. Mekonnen AG, Mittiku YM. Early-onset of sexual activity as a potential risk of cervical cancer in Africa: A review of literature. Linde DS, editor. PLOS Glob Public Health [Internet]. 2023 Mar 22 [cited 2024 Jun 23];3(3):e0000941. Available from: https://dx.plos.org/10.1371/journal.pgph.0000941
42. Jain MA, Limaiem F. Cervical Squamous Cell Carcinoma. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 May 6]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK559075/
43. Zhang S, Xu H, Zhang L, Qiao Y. Cervical cancer: Epidemiology, risk factors and screening. Chin J Cancer Res Chung-Kuo Yen Cheng Yen Chiu. 2020 Dec 31;32(6):720–8.
44. Stelzle D, Tanaka LF, Lee KK, Khalil AI, Baussano I, Shah ASV, et al. Estimates of the global burden of cervical cancer associated with HIV. Lancet Glob Health [Internet]. 2021 Feb 1 [cited 2024 May 6];9(2):e161–9. Available from: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30459-9/fulltext
45. Ibrahim Khalil A, Mpunga T, Wei F, Baussano I, de Martel C, Bray F, et al. Age‐specific burden of cervical cancer associated with HIV: A global analysis with a focus on sub‐Saharan Africa. Int J Cancer [Internet]. 2022 Mar 1 [cited 2024 Jun 23];150(5):761–72. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8732304/
46. Roura E, Castellsagué X, Pawlita M, Travier N, Waterboer T, Margall N, et al. Smoking as a major risk factor for cervical cancer and pre-cancer: results from the EPIC cohort. Int J Cancer. 2014 Jul 15;135(2):453–66.
47. Ding R, Su Z, Chen M, Chen L. Prognostic models for predicting overall and cancer-specific survival of patients with initially diagnosed metastatic cervical squamous cell carcinoma: A study based on SEER database. Medicine (Baltimore) [Internet]. 2023 Jul 14 [cited 2024 Jun 24];102(28):e34313. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344589/
48. Ministério da Saúde. República de Cabo Verde. Relatório Estatístico 2016. [Internet]. Praia; 2018. Available from: https://minsaude.gov.cv/wpfd_file/relatorio-estatistico-ministerio-da-saude-2016/
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Portuguese Journal of Surgery

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Para permitir ao editor a disseminação do trabalho do(s) autor(es) na sua máxima extensão, o(s) autor(es) deverá(ão) assinar uma Declaração de Cedência dos Direitos de Propriedade (Copyright). O acordo de transferência, (Transfer Agreement), transfere a propriedade do artigo do(s) autor(es) para a Sociedade Portuguesa de Cirurgia.
Se o artigo contiver extractos (incluindo ilustrações) de, ou for baseado no todo ou em parte em outros trabalhos com copyright (incluindo, para evitar dúvidas, material de fontes online ou de intranet), o(s) autor(es) tem(êm) de obter, dos proprietários dos respectivos copyrights, autorização escrita para reprodução desses extractos do(s) artigo(s) em todos os territórios e edições e em todos os meios de expressão e línguas. Todas os formulários de autorização devem ser fornecidos aos editores quando da entrega do artigo.