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Pregnancy and Obstetrical Outcomes Following Treatment for Cervical Intra-Epithelial Neoplasia (CIN) in Two Hospitals of a Low-Resource Country

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Advances in Reproductive Sciences 2024年第1期12卷 51-59页

作者： Bruno Kenfack Clovis-Achille Tanekeu Atem Bethel Ajong Zabdielle Blonde Goufack Kenfack patrick petignat Pierre Marie Tebeu Department of Gynecology and Obstetrics Faculty of Medicine and Pharmaceutical Science University of Dschang Dschang Camer-on Institur Supérieur des Sciences de la Santé Université des Montagnes Bangangté Cameroon Kekem MD District Hospital West Region Cameroon Department of Epidemiology and Public Health Faculty of Medicine and Pharmaceutical Science University of Dschang Dschang Cameron Geneva University Hospitals Genevas Switzerland Faculty of Medicine and Biomedical Science University of Yaounde I Yaounde Cameroon

Objective: In Cameroon, more than 80% of women suffering from cervical intraepithelial neoplasia (CIN) are within the reproductive age. This study intended to analyze the pregnancy outcomes following cervical treatment in Cameroon. Methods: This was a cohort study with two years retrospective data collection involving 82 women who underwent cervical treatment for CIN in two Cameroonian hospitals from January 2015 to December 2017. Data were collected from CIN treatment to end of pregnancy where applicable. Data analysis was done using Epi Info software version 3.5.4. Results: We collected data from 82 patients aged 27 to 48 years, with a mean age of 36.5 (SD: 5.3) years. During the study period, 33 out of 82 participants became pregnant 40.2 [29.56 - 51.66]%. The factor associated with pregnancy occurrence after treatment was age less than 35 years (Odds ratio = 4.37 [1.7 - 11.2]. From the 33 pregnancies recorded, 17 (51.5%) ended in a delivery, amongst which 15 (88.2%) were vaginal. Conclusion: Pregnancy frequency over two years following cervical treatment for CIN was relatively good, and younger women (age 35 years) were significantly more like to have conceived compared to their older counterparts. Post-treatment delivery outcomes seem to be similar to those in the general population.

关键词： Cervical Intraepithelial Neoplasia Cervical Treatment Pregnancy Outcome

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Cervical cancer screening in developing countries at a crossroad:Emerging technologies and policy choices

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World Journal of Clinical Oncology 2015年第6期6卷 281-290页

作者： Rosa Catarino patrick petignat Gabriel Dongui Pierre Vassilakos Division of Gynaecology Department of Gynaecology and ObstetricsGeneva University Hospitals Division of Gynaecology Department of Gynaecology and ObstetricsUniversity Hospital of Yopougon Geneva Foundation for Medical Education and Research

Cervical cancer(CC) represents the fourth most common malignancy affecting women all over the world and is the second most common in developing areas. In these areas,the burden from disease remains important because of the difficulty in implementing cytology-based screening programmes. The main obstacles inherent to these countries are poverty and a lack of healthcare infrastructures and trained practitioners. With the availability of new technologies,researchers have attempted to find new strategies that are adapted to low- and middle-income countries(LMIC) to promote early diagnosis of cervical pathology. Current evidence suggests that human papillomavirus(HPV) testing is more effective than cytology for CC screening. Therefore,highly sensitive tests have now been developed for primary screening. Rapid molecular methods for detecting HPV DNA have only recently been commercially available. This constitutes a milestone in CC screening in low-resource settings because it may help overcome the great majority of obstacles inherent to previous screening programmes. Despite several advantages,HPV-based screening has a low positive predictive value for CC,so that HPVpositive women need to be triaged with further testing to determine optimal management. Visual inspection tests,cytology and novel biomarkers are some options. In this review,we provide an overview of current and emerging screening approaches for CC. In particular,we discuss the challenge of implementing an efficient cervical screening adapted to LMIC and the opportunity to introduce primary HPV-based screening with the availability of point-of-care(POC) HPV testing. The most adapted screening strategy to LMIC is still a work in progress,but we have reasons to believe that POC HPV testing makes part of the future strategies in association with a triage test that still needs to be defined.

关键词： Low-and middle-income countries Cervical cancer screening Human papillomavirus testing

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