Analysis of Cervical Cancer Management at Primary and Tertiary Healthcare Facilities in Rivers State

Abstract

Cervical cancer remains a significant public health concern, and differences in management between primary and tertiary healthcare facilities may influence early detection and treatment outcomes. This study aimed to compare cervical cancer prevalence and management between a tertiary (RSUTH) and primary healthcare facility (PHC Ozuoba) in Rivers State. A retrospective cross-sectional design reviewed 6,020 women screened from 2021 to 2023. Data on sociodemographics, risk factors, management, and follow-up were extracted from hospital records. Descriptive statistics and chi-square tests were used to assess differences between facilities. Overall prevalence was 1.0% (95% CI: 0.8–1.3%), with RSUTH at 1.1% (95% CI: 0.8–1.5%) and PHC Ozuoba at 0.9% (95% CI: 0.6–1.3%). Most positive cases were aged 30 39 years (48.4%), with similar age distributions across facilities. Risk factors, including multiple sexual partners, oral contraceptive use, and high parity, were comparable. Screening methods differed significantly: VIA was more frequent at RSUTH (75.7%) than PHC (24.3%, p < 0.001), while PAP smear was performed only at RSUTH (100%, p = 0.011). Thermal ablation was the primary treatment at both facilities, but RSUTH managed a higher proportion of cases via this method (48.1% vs 51.9%, p = 0.015). Post-treatment follow-up showed limited cured cases, with no significant difference between RSUTH and PHC (2.9% vs 0%, p = 0.548). Cervical cancer prevalence was similar across facilities, but tertiary care offered broader screening and treatment capacity. Strengthening management resources and follow-up protocols at primary healthcare centres is recommended to improve patient outcomes.