Frequency and Pattern of Gynecological Cancers in Federal Teaching Hospital, Abakaliki, Nigeria

Background: Gynecological cancers are common and are among the leading causes of cancer‑related deaths worldwide. Aim: The objective of this study was to determine the pattern and relative frequencies of gynecological cancers as seen at the Federal Teaching Hospital, Abakaliki, Nigeria. Materials and Methods: A 2‑year retrospective study of female genital tract malignancies was conducted at the Federal Teaching Hospital, Abakaliki. The case notes of patients admitted for female genital tract malignancy between January 1, 2012 and December 31, 2013 were retrieved from the ward admissions and discharge books and the operating theater record books. The data were analyzed using Statistical Package for Social Science (SPSS), IBM SPSS statistics Version 20, IBM incorporation and licensors 1989,2011 New York USA and the results expressed in descriptive statistics by simple percentages. Result: A total of 1,178 women were seen during the study period, while 99 were found to have gynecological malignancy. The proportion of gynecological malignancies was 8.4%. Majority of the patients were in the 5th and 6th decades of life, most (60.6%) had cervical cancer, followed by ovarian cancer (19.2%), endometrial cancer (10.1%) vulva cancer (7.1%), and the least was choriocarcinoma (3.0%). Tumors of fallopian tube and vagina were not seen during the study period. Majority of the patients presented late and the common presentation was vaginal bleeding. Conclusion: Despite the preventable nature of cancer of cervix, it remained the most common female genital tract malignancy in Abakaliki, southeast Nigeria. Education and public enlightenment on the importance of routine screening and treatment of premalignant lesions of the cervix are necessary tools to reduce the incidence and mortality of cervical cancer.KEY WORDS: Abakaliki, cancer, frequency, gynecologic, gynecological cancer, Nigeria, patter

Impact of visual inspection with acetic acid plus cryotherapy “see and treat” approach on the reduction of the population burden of cervical preinvasive lesions in Southeast Nigeria

Objective: The aim of this study is to determine the impact of visual inspection with acetic acid (VIA) plus immediate cryotherapy on the prevalence of VIA‑detected cervical squamous intraepithelial lesion (SIL).Methods: Women in four rural communities in Southeast Nigeria were screened with VIA. Women who tested positive to VIA were offered either immediate cryotherapy or large loop excision of the transformation zone based on predetermined eligibility criteria. Cervical biopsies were taken before cryotherapy and examined by consultant histopathologists. All participants were rescreened 1 year later. The main outcome measures were population prevalence of cervical precancers before and after intervention, cure rates, and over‑treatment rates.Results: A total of 653 women participated in the study. The prevalence of cervical SIL before the intervention was 8.9% (58/653). The prevalence 1 year later was 1.4% (9/649). This gave an 84.3% reduction in the population prevalence of SIL. The reduction in cervical SIL prevalence was statistically significant (P = 0.0001). The prevalence of high‑grade SIL reduced significantly from 4.1% (27/653) preintervention to 0.5% (3/649) 1 year postintervention (P = 0.0001). This gave an 87.8% reduction in the population prevalence of high‑grade SIL. Cryotherapy provided a cure rate of 87.9% (95% confidence interval: 76.82–94.33).Conclusion: Population cervical cancer prevention using VIA plus immediate cryotherapy leads to significant reduction in the population prevalence of cervical SIL. This has the potential of being an acceptable supplement to cervical cytology for cervical cancer prevention in low‑income populations.Key words: Cervical cancer, cryotherapy, impact, see and treat, visual inspection with acetic aci