Раковая наука и терапия

Socio-Demographic Factors Associated with Advanced Stage of Cervical Cancer at Diagnosis in Kenyatta National Hospital, Kenya: A Cross Sectional Study

Abstract

Kirema Makena Frida, Wagoro Miriam Carole Atieno and Michael Habtu

Background: Cervical cancer is the most common and leading cause of deaths due to cancer among women in Kenya. Early detection is necessary for initiation of treatments to prevent deaths. Identification of factors that contribute to advanced stage of cervical cancer is the first step towards early detection. Objectives: To determine socio-demographic factors associated with advanced stage of cervical cancer at diagnosis in Kenyatta National Hospital. Materials and methods:A cross-sectional study of 152 women with a histological proven cervical cancer was conducted at Kenyatta National Hospital. The women were selected using random sampling method. Information on demographic characteristics and stage of cervical cancer were abstracted retrospectively by auditing patients’ records from January 2014 to June 2014. Stages I and II were classified as ‘early stage’ and stages III and IV as ‘advanced stage’. Chi-square test (p-value<0.05) was used to determine association between advanced stage of cervical cancer and socio-demographic characteristics. Multiple logistic regression analysis was performed to determine the independent factors associated with advanced stage of cervical cancer at diagnosis. Results: Out of 152 patients with cervical cancer, 53.9% had advanced stage of cancer at diagnosis. Following multiple logistic regression analysis, the following factors were independently associated with advanced stage of cervical cancer: older age (50 to 75 years) (AOR=4.25; 95% CI=1.08-16.75; P=0.039), being single (AOR=2.28; 95% CI=1.03-5.06; P=0.043), never attended school (AOR=5.91; 95% CI=1.96-17.78; P=0.002), attended primary school (AOR=4.13; 95% CI=1.60-10.63; P=0.003) and HIV positive women (AOR=2.86; 95% CI=1.25-6.59; P=0.013). Conclusion:More than half of the patients presented with advanced stage of cervical cancer at diagnosis. None/low level of education, old age, being single and HIV infection were associated with advanced stage of cancer at diagnosis. Regular cervical cancer screening targeting these women could reduce advanced stage of cervical cancer at diagnosis.