Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
HUMAN PAPILLOMAVIRUS AND HUMAN IMMUNODEFICIENCY VIRUS INFECTION IN RELATION TO CERVICAL CANCER: STUDIES AND OBSERVATIONS OF BASIC CLINICAL AND EPIDEMIOLOGICAL ASPECTS OF CANCER OF THE CERVIX WITH SPECIAL REFERENCE TO KENYA, AFRICA
Diss Abstr Int [C]; 52(1):91 1991. Unique Identifier : AIDSLINE ICDB/91676168 Rogo KO; Umea Universitet, Sweden
Abstract:
Carcinoma of the cervix is the most common female malignancy in Kenya. No screening program has been started in the country and, with only one public hospital with a high-energy radiation facility, few women receive optimal care. Little is known about the epidemiology of the disease in Kenya, although it is clear that smoking and contraceptive use are unlikely to play a major role due to their low prevalence. Analysis of clinical features in 1210 patients treated in Nairobi between 1978-1984 revealed a mean age of 42 yr and frequent high parity. Only 7% presented with Stage I disease. Follow-up was extremely poor. In an analysis of knowledge and attitudes, ignorance about the disease and preventive measures was confirmed in both cases and controls. Lack of appropriate information and cultural beliefs described may hamper the successful introduction of a screening program. Analysis of human papillomavirus (HPV) DNA in cervical smears from cytologically normal FP clinic attenders in Nairobi by PCR showed positivity in 19.5%, a figure comparable to current rates in low-risk women in Umea, Sweden. In squamous cervical cancer biopsies from Kenya, HPV 16 DNA was detected in 85%, HPV 18 in 69% and HPV 6 in only 23%. Double infection with HPV 16 and 18 was common (62%). Using PCR on archival paraffin-embedded biopsies from cervical adenocarcinoma from Sweden, HPV DNA detection rate was 42%; 15% were HPV 16 and 27% HPV 18. This confirmed recent reports of HPV involvement in cervical adenocarcinomas. Human immunodeficiency virus seroprevalence in 200 cervical cancer patients in Kenya was only 1.5%, much lower than in known high-risk groups but comparable low-risk groups. The findings and observations highlight the problem of cervical cancer in Kenya which is not dissimilar to other African countries. Critical issues to be overcome if incidence and mortality are to be reduced are discussed. The prevalence of human papillomavirus is analyzed and the need for further studies to identify, explore and quantify the importance of specific risk cofactors peculiar to a high prevalence area like Kenya discussed.
Keywords: Adult Cervix Neoplasms/EPIDEMIOLOGY/*ETIOLOGY DNA, Viral/ANALYSIS Female Human HIV Infections/*COMPLICATIONS Kenya/EPIDEMIOLOGY Papillomavirus/GENETICS/*ISOLATION & PURIF Polymerase Chain Reaction Risk THESIS 912130
M91C4078
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
