Effect of misoprostol on type 3 transformation zone of the cervix among Cameroonian women

Simon M Manga; Margaret I Liang; Yuanfan Ye; Jeff M Szychowski; Kathleen L Nulah; Alan T Tita; Isabel Scarinci; Warner K Huh

doi:10.1016/j.gore.2022.100944

Effect of misoprostol on type 3 transformation zone of the cervix among Cameroonian women

Gynecol Oncol Rep. 2022 Mar 1:40:100944. doi: 10.1016/j.gore.2022.100944. eCollection 2022 Apr.

Authors

Simon M Manga^{1

2}, Margaret I Liang^{2

3}, Yuanfan Ye², Jeff M Szychowski^{2

4}, Kathleen L Nulah¹, Alan T Tita^{2

5}, Isabel Scarinci^{2

3}, Warner K Huh^{2

3}

Affiliations

¹ Women's Health Program, Cameroon Baptist Convention Health Services, Bamenda, P.O. Box 1, Nkwen, Bamenda, Cameroon.
² Center for Women's Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA.
³ Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite10250, Birmingham, AL 35233, USA.
⁴ Department of Biostatistics, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA.
⁵ Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1717 11th Avenue South, MT Birmingham, AL 35233, Birmingham, AL, USA.

Abstract

Background: Type 3 transformation zone (TZ) of the cervix has been shown to be associated with a four to five-fold increased risk of missed precancerous/cancerous lesions. The aim of this study was to evaluate the effect of intravaginal misoprostol on the TZ among women with Type 3 TZ in Cameroon.

Materials and methods: A single dose of vaginal misoprostol (400 mcg or 600 mcg) was administered as part of the plan of care for women with Type 3 TZ during cervical cancer screening. The primary outcome was successful conversion from Type 3 TZ to Types 1 or 2 TZ. Descriptive analysis was performed using chi-square and Fisher's exact tests.

Results: Among the 90 of 107 (84.2%) women who returned for re-evaluation of the cervix, 43 (47.8%, 95% CI: 0.36%-0.60%) had conversion of Type 3 TZ to Types 1 or 2. Women who received misoprostol 600 mcg were more likely to have their Type 3 TZs converted to Types 1 or 2 than women receiving 400 mcg (p = 0.037).

Conclusion: Misoprostol converted approximately 50% of Type 3 TZ to Types 1 or 2 in Cameroon. Misoprostol is feasible in converting Type 3 TZ to Types 1 or 2 among Cameroonian women.

Keywords: Cameroon; Cervix uteri; Misoprostol; Precancerous conditions.

Grants and funding

P50 CA098252/CA/NCI NIH HHS/United States