Osita Samuel Umeononihu^1,2, Martin Chinedu Andeh², George Uchenna Eleje^1,2*, Onyeka Chukwudalu Ekwebene³, Sylvester Onuegbunam Nweze⁴, Nnanyereugo Livinus Onah⁴, Chidinma Theresa Ezidiegwu², Chukwuemeka Jude Ofojebe^1,2, Chijioke Ogomegbunam Ezeigwe^1,2, Onyecherelam Monday Ogelle^1,2, Boniface Chukwuneme Okpala⁵, Ekene Agatha Emeka⁵, Johnbosco Emmanuel Mamah⁶, Chekwube Martin Obianyo⁷, Chukwuemeka Chidindu Njoku², Emeka Franklin Okechukwu⁸ and Gerald Okanandu Udigwe^1,2

¹Department of Obstetrics and Gynaecology, Nnamdi Azikwe University, Awka, Nigeria
²Department of Obstetrics and Gynaecology, Nnamdi Azikwe University Teaching Hospital, Nnewi, Nigeria
³Department of Biostatistics and Epidemiology, East Tennessee State University, Johson City, Tennessee USA
⁴Department of Obstetrics and Gynecology, ESUT Teaching Hospital, Parklane, Enugu, Nigeria
⁵Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital, Nigeria
⁶Department of Obstetrics and Gynecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
⁷Jiann-Ping Hsu College of Public Health, Georgia Southern University, USA
⁸Department of Maternal and Child Health, Global Health, US Agency for International Development (USAID), Nigeria

*Corresponding Author: George Uchenna Eleje, Department of Obstetrics and Gynaecology, Effective Care Research Unit, Nnamdi Azikiwe University, Awka (Nnewi Campus), P.M.B. 5001, Nnewi, Anambra State, Nigeria.

Received: March 07, 2025; Published: May 06, 2025

Abstract

Background: Cervical cancer is the most common gynaecological malignancy in low- and middle-income countries, including Nigeria, where it remains a major cause of morbidity and mortality. Despite being largely preventable through screening and vaccination, late-stage presentation remains a significant challenge.

Objectives: To determine the prevalence, associated risk factors, and clinical presentation of histologically confirmed cervical cancer cases at a tertiary hospital in South-East Nigeria.

Materials and Methods: A five-year retrospective study was conducted at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, covering cases from January 1, 2017, to December 31, 2021. Data were obtained from hospital records, including the gynaecology clinic, gynaecology ward, histopathology department, and operating theatre registers. Only histologically confirmed cases were included. Relevant patient information was retrieved from case notes, entered into SPSS version 25, and analysed using descriptive statistics.

Results: A total of 103 cervical cancer cases were identified, accounting for 49.3% of all gynaecological malignancies. The highest incidence occurred in women aged 60–69 years (34.7%), with grand multiparity being the most common reproductive history (73.7%). The predominant symptom at presentation was irregular vaginal bleeding (84.2%), with most patients experiencing multiple symptoms. Late-stage diagnosis was prevalent, with 75.4% of cases presenting at stage III. Squamous cell carcinoma was the most common histological type (90.5%). None of the patients had undergone prior cervical cancer screening or received the HPV vaccine. Due to the unavailability of radiotherapy services at the facility, 94.7% of patients were referred to another tertiary center for treatment.

Conclusion: Cervical cancer remains the leading gynaecological malignancy in this setting, with late-stage presentation and lack of access to radiotherapy posing significant challenges. Increased public awareness, improved screening uptake, and enhanced healthcare infrastructure, including accessible radiotherapy services, are crucial for improving outcomes.

 Keywords: Histologically Confirmed; Prevalence; Radiotherapy; Screening; Squamous Cell Carcinoma; NAUTH; Nigeria

References

1. Siegel RL., et al. “Cancer statistics, 2022”. CA: A Cancer Journal for Clinicians1 (2022): 7-33.
2. Kani YA., et al. “Prevalence of cervical cancer - A 6-year retrospective study in Jigawa State, Nigeria”. World Journal of Biology Pharmacy and Health Sciences1 (2020): 8-13.
3. Sung H., et al. “Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries”. CA: A Cancer Journal for Clinicians3 (2021): 209-249.
4. Torre LA., et al. “Global cancer statistics, 2012”. CA: A Cancer Journal for Clinicians 2 (2015): 87-108.
5. Bruni L., et al. “ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre)”. Human Papillomavirus and Related Diseases in Nigeria. Summary Report (2021).
6. Simelela PN. “WHO global strategy to eliminate cervical cancer as a public health problem: An opportunity to make it a disease of the past”. International Journal of Gynecology and Obstetrics1 (2021): 1-3.
7. Ilika CP., et al. “Effects of speculum lubrication on cervical smears for cervical cancer screening: A double blind randomized clinical trial”. PLoS One5 (2024): e0292207.
8. Umemmuo MU., et al. “Improving Treatment Outcome for Cervical Cancer Using 2-Point Assessment of Quality of Life Among Nigerian Women: A Protocol for a Multi-Center Study”. Clinical Medicine Insights: Oncology 17 (2023): 11795549231212339.
9. Enechukwu CI., et al. “Comparative study on the adequacy of cervical smears using wooden Ayre's spatula, VS Papcone® sampling device”. Gynecologic Oncology Reports 38 (2021): 100860.
10. Eleje GU., et al. “Palliative interventions for controlling vaginal bleeding in advanced cervical cancer”. Cochrane Database of Systematic Reviews 5 (2025): CD011000.
11. Eke NO., et al. “Knowledge of Cervical Cancer and its Screening amongst Female Workers in Nnewi, Nigeria”. Afrimedic Journal1 (2010): 31-33.
12. Ezechi O., et al. “High-risk human papillomavirus infection among Nigerian women: A systematic review and meta-analysis”. Journal of International Medical Research 7 (2023): 3000605231182884.
13. Frumovitz M. “Invasive cervical cancer: Epidemiology, risk factors, clinical manifestations, and diagnosis”. Uptodate (2022).
14. Allagoa DO., et al. “Cervical Cancer in a Tertiary Hospital in South-South, Nigeria: A 5-Year Review”. JCTI (2021): 28-36.
15. Yakasai IA., et al. “Gynecological malignancies in Aminu Kano Teaching Hospital Kano: A 3 year review”. Nigerian Journal of Clinical Practice 16 (2013): 63-66.
16. Olaleye AA., et al. “Profile of Gynaecological Malignancies in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Southeastern Nigeria”. IJCM 10 (2019): 428-438.
17. Umeobika JC., et al. “Gynaecological Malignant Tumours at Imo State University Teaching Hospital Orlu South Eastern Nigeria”. Afrimedic Journal 1 (2018): 52-58.
18. Sanni WO., et al. “Pattern of Gynaecological Malignancies in Jos”. Tropical Journal of Obstetrics and Gynaecology 30 (2013): 97-100.
19. Ikechebelu JI., et al. “Clinicopathological analysis of cervical cancer seen in a tertiary health facility in Nnewi, south-east Nigeria”. Journal of Obstetrics and Gynaecology 30 (2010): 299-301.
20. Awolude OA and Oyerinde SO. “Invasive cervical cancer in Ibadan: socio-sexual characteristics, clinical stage at presentation, histopathology distributions and HIV status”. African Journal of Infectious Diseases1 (2018): 32-38.
21. Musa J., et al. “Cervical cancer survival in a resource-limited setting-North Central Nigeria”. Infectious Agents Cancer 11 (2016).

Citation

Citation: Osita Samuel Umeononihu., et al. “Prevalence and Changing Trend in the Clinical Presentation of Cervical Cancer at A Tertiary Hospital in South-East Nigeria”.Acta Scientific Medical Sciences 9.56 (2025): 04-11.

Copyright

Copyright: © 2025 Osita Samuel Umeononihu., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.