Prevalence and Factors Associated with Cervical Precancerous Lesions Among Women Aged 30 Years and Above in the Penka-Michel Health District, Cameroon: An Analytical Cross‑Sectional Study Using Pap Smear Screening
Prévalence et Facteurs Associés aux Lésions Précancéreuses du Col de L'utérus Chez les Femmes de 30 Ans et Plus dans le District de Santé de Penka-Michel, Cameroun : Une Etude Transversale Analytique par Frottis Cervico-Vaginal
DOI:
https://doi.org/10.67260/hra.v4i8.7899Keywords:
Prevalence, Cervical precancerous lesions, Women aged 30 Years, Penka-Michel Health DistrictAbstract
ABSTRACT
Introduction. Cervical cancer is the fourth most common cancer in women worldwide, but data on precancerous lesions in rural Cameroon are scarce. This study determined the prevalence of cervical precancerous lesions and associated factors among women aged 30 years and above in the Penka-Michel Health District, Cameroon. Methods. We conducted a cross‑sectional analytical study from April to June 2025, recruiting 398 women from all 13 health areas in the district. We collected data using a pre‑tested questionnaire and screened for cervical precancerous lesions using Pap smear testing. We used chi‑square and multinomial logistic regression to test associations, with significance set at p<0.05. Results. Most participants were aged 30‑39 years (33.7%), married (74.4%), and had completed primary education (71.6%). The prevalence of cervical precancerous lesions was 15.8% (63/398): low‑grade lesions in 6.0% and high‑grade lesions in 9.8%. In multivariate analysis, factors independently associated with lower odds of lesions were: higher education level (OR=0.219; 95% CI 0.071‑0.679; p=0.008), residence in the West Region (OR=0.307; 95% CI 0.131‑0.718; p=0.006), history of STI (OR=0.199; 95% CI 0.062‑0.639; p=0.007), and partner history of genital ulcer (OR=0.293; 95% CI 0.140‑0.611; p=0.001). Conclusion. Cervical precancerous lesions affect one in six women in the Penka-Michel Health District. Efforts to improve education, promote safe sexual practices, and strengthen screening programmes are urgently needed.
RÉSUMÉ
Introduction. Le cancer du col de l'utérus est le quatrième cancer le plus fréquent chez la femme dans le monde, mais les données sur les lésions précancéreuses au Cameroun rural sont rares. Cette étude a déterminé la prévalence des lésions précancéreuses du col de l'utérus et les facteurs associés chez les femmes âgées de 30 ans et plus dans le district de santé de Penka-Michel, Cameroun. Méthodes. Étude transversale analytique menée d'avril à juin 2025, incluant 398 femmes de l'ensemble des 13 aires de santé du district. Nous avons recueilli les données par questionnaire pré-testé et dépisté les lésions précancéreuses par frottis cervico-vaginal. Nous avons utilisé les tests du Chi² et la régression logistique multinomiale, avec un seuil de signification p<0,05. Résultats. La plupart des participantes étaient âgées de 30‑39 ans (33,7 %), mariées (74,4 %) et de niveau primaire (71,6 %). La prévalence des lésions précancéreuses était de 15,8 % (63/398) : lésions de bas grade 6,0 % et de haut grade 9,8 %. En analyse multivariée, les facteurs associés à une moindre probabilité de lésions étaient : un niveau d'instruction plus élevé (OR=0,219 ; IC95 % 0,071‑0,679 ; p=0,008), la résidence dans la région de l'Ouest (OR=0,307 ; IC95 % 0,131‑0,718 ; p=0,006), des antécédents d'IST (OR=0,199 ; IC95 % 0,062‑0,639 ; p=0,007) et des antécédents d'ulcère génital chez le partenaire (OR=0,293 ; IC95 % 0,140‑0,611 ; p=0,001). Conclusion. Les lésions précancéreuses du col de l'utérus touchent une femme sur six dans le district de Penka-Michel. Des efforts pour améliorer l'éducation, promouvoir des pratiques sexuelles sûres et renforcer les programmes de dépistage sont urgents.
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