High burden of abnormal cervical smears in South African primary health care

Health programmes implications

Bibliographic Data

ID22944598
AuthorsOlufemi Babatunde Omole (0000-0002-4621-1378, University of the Witwatersrand), John M Francis (0000-0003-1902-2683, University of the Witwatersrand), John M Musonda (0000-0003-2942-1039, University of the Witwatersrand), Pumla Pamella Sodo (0000-0002-2542-6038, University of the Witwatersrand), Elizabeth Reji (0000-0001-6404-0165, Department of Family Medicine, University of Free State , Universitas Academic Hospital,1 Logeman Street, Bloemfontein 9301), Nyundu S J Phukuta (0000-0001-8555-2928, Sefako Makgatho Health Sciences University), Honey L M Mabuza (Sefako Makgatho Health Sciences University), Langalibalele H Mabuza (0000-0001-6463-4297, Sefako Makgatho Health Sciences University), Joyce Sikwese Musonda (University of the Witwatersrand), Jimmy Akii (University of the Witwatersrand), John V Ndimande (Sefako Makgatho Health Sciences University), Olalekan A Ayo-Yusuf (University of Pretoria), Olalekan Ayo‐Yusuf (0000-0003-0689-7018, University of Pretoria)
Year2025
Volume40
Issue1
Publication date2025-01-17
Open AccessYes
TypeARTICLE
VenueHealth Promotion International (JOURNAL)
Journal identifiersISSN: 0957-4824 • E-ISSN: 1460-2245
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1093/heapro/daae162
PMID39883051
OpenAlexW4406967633
LanguageEN
References cited31

Cervical cancer is the second most common malignancy among South African women and the load of abnormal cervical smears has clinical, programmatic and policy implications. This cross-sectional study of women who presented for cervical cancer screening aimed to determine the prevalence of abnormal cervical smears and associated factors in primary health care (PHC) facilities in Gauteng—the most densely populated province in South Africa. A questionnaire collected data on socio-demography, tobacco use, sexual behaviours, HIV status, past treatment for sexually transmitted infections (STI) and cervical cancer screening in the past 10 years. Cytology reports were extracted from the laboratory reports. Of 749 participants, most were black (89.7%), aged 30–49 years (62.2%), single (57.5%) and attained high school education (76.8%). About 43.9% were HIV positive with almost all (97.2%) on antiretroviral therapy. Cytology results were available for 612 (81.9%) participants. Of these, 25.8% (159) were abnormal: 13.2% low-grade squamous intraepithelial lesion; 5.7% atypical squamous cells of undetermined significance and 4.9% high-grade squamous intraepithelial lesion. In bivariate and multivariable analysis, abnormal cervical cytology was not associated with any sociodemographic characteristics, HIV status, tobacco use status, sexual behaviours or past treatment for STI. In conclusion, the prevalence of abnormal cervical smears is high across all demographic groups and irrespective of HIV status and highlights the need to increase screening uptake, including advocacy for self-sampling. It also calls for capacity building to allow for the devolution of some downstream clinical care from specialist to district hospitals and large PHC facilities.

Cancer · Cervical cancer · Cervical intraepithelial neoplasia · Gynecology · Malignancy · Obstetrics · Squamous intraepithelial lesion · Cervical Cancer and HPV Research · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Reproductive tract infections research

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