TITLE:
Contribution of Colposcopy in the Diagnosis of Precancerous Lesions of the Uterine Cervix at the Douala Gynaeco-Obstetric and Pediatric Hospital, Cameroon
AUTHORS:
Diane Estelle Modjo Kamdem, Alphonse Nyong Ngalame, Inna Rakya, Robert Tchounzou, Darolles Wekam Mwadjie, Humphry Tatah Neng, Bilkissou Moustapha, Julie Batta, Patricia Metouom Kamdem, Charlotte Nguefack Tchente, Emile Mboudou
KEYWORDS:
Colposcopy, Cervix, Dysplasia, Cancer, DGOPH
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.10,
October
19,
2022
ABSTRACT:
Introduction: Cervical cancer is a public health problem in Cameroon, due to low
screening and late diagnosis. We sought to assess practice of colposcopy at the
Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) in Cameroon and its
contribution to the fight against cervical cancer in our context. Method:
This is a retrospective cross-sectional study of 99 colposcopies after which 71
exploitable biopsies were retained at the Douala for a period of 1year
(December 1, 2019-December 1, 2020). The nomenclature of the French Society of
Colposcopy and Cervico-Vaginal Pathology (SFCPCV) was used. Results: Mean age of the participants was 44 years, mostly multiparous (80%).
Cytological abnormalities were the main reference pattern. During the
examination 22% of colposcopies were found to be normal, 37% of TAG 1-2A, 31%
of TAG 2B-C, and 5% suspected of cancer. After histological analysis of
biopsies guided by colposcopy, we found 42% (30/71) of Cervical Intraepithelial
Neoplasia (CIN) 1, 15.5% (11/71) of CIN 2 - 3, and 24% (17/71) cancer. Upon
analysis of the diagnosed CIN1/CIN2-3/Cancers, we noted a concordance with
colposcopy in 62% (23/37), 37% (10/27) and 85% (6/7) respectively. Colposcopic
performance in the detection of high-grade lesions and above was 36% (26/71),
with a sensitivity of 92.86%, specificity 83.33%, PPV 78.79% and NPV 94.59%. Conclusion: Despite the difficult socioeconomic context, colposcopy retains all its
importance in the diagnosis of precancerous lesions of the uterine cervix. With
the imminent putting in place of a national health policy, the goals 90-70-90
by 2030 of the World Health Organization for the fight against cervical cancer
can be achieved in our sub-Saharan African countries.