Abstract:
Background of the study: Cervical cancer is a disease that is described as the state
of overgrowth of tissue resulting from the disorganisation of cell division that is
preceded by several earlier cervical changes, especially at the squamocolumnar
junction of the cervix. Factors such as HPV, which is a sexually transmitted infection
(STI), low socioeconomic status (SES), intercourse at a very early age, numerous
childbirths, poverty and limited access to health care, are some of the contributing risk
factors for cervical cancer. Most women in developing countries only seek professional
help once the malignancy is already at an advanced stage.
Purpose of the study: The aim of the study was to investigate the determinants of
cervical cancer in patients seen in the gynaecology clinic at Mankweng hospital. And
the objectives were: to profile the sociodemographic characteristics; to profile the
contributory risk factors; and, to determine the association of risk factors for cervical
cancer with the socio-demographic characteristics of the patients seen in the
gynaecology clinic at Mankweng hospital.
Research methodology: A quantitative, cross-section descriptive study, which has
been validated and used in several studies globally, was conducted at Mankweng
hospital, which is a tertiary referral academic hospital in the Limpopo Province,
following all cervical cancer patients consulting at gynaecology outpatient clinic during
the study period. Data were collected using a structured questionnaire and entered
into computer software and analysed.
Research findings: Thirty-seven percent of the women who participated in this study
were single, 27% were married, 27% widowed and only 9% were divorced. Nearly half
(46%) of the participants had secondary education and only 8% had tertiary education.
The majority (91%) of the women were unemployed and only 9% were employed. The
majority (40%) of the women were at stage II cervical cancer. Nearly two-thirds (62%)
had had multiple partners. At the time of the study, 94% of the participants did not
have multiple partners. Nearly two-thirds (64%) of the participants had heard about
Pap smears before their current diagnosis and 62% of the participants had had a Pap
smear before the current results. Few participants smoked cigarette (2%) or used
contraceptive (3%). The young age group, single, divorced, with secondary and
v
tertiary education were more likely to be HIV positive. And the elderly, divorced,
widowed and less educated were more likely to have high parity.
Recommendations and conclusions: Information about the risk factors for
developing cervical cancer, specifically the transmission of HPV, needs to be
disseminated to young people. Rather than initiating cervical screening by age group,
which may result in young women being refused screening irrespective of their risk,
cervical screening guidelines should stipulate the initiation of cervical screening and
HPV vaccine from the age of 15 onwards. Present study suggests that young women
may be more prone to HPV and HIV due to the fact that young women who are single
or divorced, with tertiary education were more likely to have multiple partners, which
places them in a risk-based cervical screening target group. A final recommendation
and conclusion is that a long-term, in-depth study on cervical cancer in young women
in relation to the presence of the risk-factors should be carried out. Attempts should
be made to reach women who rarely visit health care services.