Histopathological profile of cervical biopsies in northern Malawi: a retrospective cross-sectional study

Paul Uchizi Kaseka; Alfred Kayira; Chikondi Sharon Chimbatata; Master R O Chisale; Pocha Kamudumuli; Tsung-Shu Joseph Wu; Balwani Chingatichifwe Mbakaya; Frank Watson Sinyiza

doi:10.1136/bmjopen-2020-048283

Histopathological profile of cervical biopsies in northern Malawi: a retrospective cross-sectional study

BMJ Open. 2022 Mar 11;12(3):e048283. doi: 10.1136/bmjopen-2020-048283.

Authors

Paul Uchizi Kaseka¹, Alfred Kayira², Chikondi Sharon Chimbatata³, Master R O Chisale⁴, Pocha Kamudumuli⁵, Tsung-Shu Joseph Wu⁶, Balwani Chingatichifwe Mbakaya⁷, Frank Watson Sinyiza⁸

Affiliations

¹ Paediatrics Department, Mzuzu Central Hospital, Mzuzu, Malawi kasekapaul2016@gmail.com.
² Laboratory Department, Mzuzu Central Hospital, Mzuzu, Malawi.
³ Paediatrics Department, Mzuzu Central Hospital, Mzuzu, Malawi.
⁴ Biological Sciences, Mzuzu University, Mzuzu, Malawi.
⁵ Laboratory, University of Maryland and Global Initiative Company, Lilongwe, Malawi.
⁶ Research, Ping Tung Christian Hospital, Pingtung, Taiwan.
⁷ Public Health, University of Livingstonia, Mzuzu, Malawi.
⁸ Clinical Department, Mzuzu Central Hospital, Mzuzu, Malawi.

Abstract

Objectives: According to the WHO (2014), cervical cancer is the second most common cancer in women globally. More than 85% of the global cervical cancer morbidity and mortality occur in low-income and middle-income countries and the highest risk region is in Eastern and Southern Africa. Malawi has the highest age-standardised rate of cervical cancer in the world. This study was carried out to determine the histopathological profile of cervical biopsies in a public tertiary hospital in Mzuzu, northern region of Malawi.

Setting: A public tertiary hospital in Mzuzu, northern region of Malawi.

Participants: This was a retrospective study of all cervical biopsy specimen reports received in a public tertiary hospital in northern Malawi over a period of 5 years from July 2013 to June 2018. Demographic, clinical and diagnostic data were obtained from original histopathology reports.

Results: A total of 500 cervical biopsy reports were reviewed during the study period. The mean age of the patients was 41.99±12.5. Age ranged from 15 to 80 years. Cervicitis accounted for 46.0% (n=162) of the total non-malignant lesions seen, followed by cervical intraepithelial neoplasm, at 24.4% (n=86) and endocervical polyp, at 20.5% (n=72). Squamous cell carcinoma (SCC) accounted for 15.6% (n=78) of the total cervical biopsies studied and 85.7% of all total malignant lesions. Adenocarcinoma and undifferentiated carcinoma were 8.8% and 4.4%, respectively of the total malignant diagnosis. All patients with malignant lesions had HIV.

Conclusion: Our study shows that cervicitis and SCC were most common among non-malignant and malignant cervical biopsies, respectively. Since the frequency of cervical cancer is high, there is a need to have well detailed national policies to be put in place to increase detection of preinvasive lesions in order to reduce the prevalence of cervical cancer.

Keywords: cervical biopsies; cervical cancer; cervical intraepithelial neoplasm; cervicitis; malignant.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Biopsy
Carcinoma, Squamous Cell* / epidemiology
Cross-Sectional Studies
Female
Humans
Malawi / epidemiology
Middle Aged
Retrospective Studies
Uterine Cervical Neoplasms* / diagnosis
Uterine Cervical Neoplasms* / epidemiology
Uterine Cervical Neoplasms* / pathology
Uterine Cervicitis*
Young Adult