Associated factors and control measures for cervical precancerous lesions in the Mifi Health District, Cameroon: a case-control study
TL;DR
Strengthening HPV vaccination, screening and timely treatment is essential for cervical cancer prevention in Cameroon, and multiple risk factors and major prevention gaps were identified.
Abstract
Cervical cancer remains a major public health problem in low- and middle-income countries, despite being largely preventable. In Cameroon’s Mifi Health District, preventive services remain underused. We identified factors associated with cervical precancerous lesions and assessed selected control measures. A retrospective case-control study was conducted at Bafoussam Regional Hospital in 2024 among 348 women aged 30-49: 87 cases (low-grade squamous intraepithelial lesions [LSIL] or high-grade squamous intraepithelial lesions [HSIL]) and 261 controls with normal cytology (1:3 ratio). Logistic regression was used; control measures were compared with World Health Organization (WHO) elimination targets. Lesions were independently associated with human papillomavirus (HPV) 16/18 positivity (adjusted odds ratio [ORa]=5.94; 95% confidence interval [CI]: 2.3-9.5), non-use of condoms (ORa=4.2; 95% CI: 2.1-8.5), gynecological symptoms (ORa=3.7; 95% CI: 2.0-6.8), HIV seropositivity (ORa=3.6), hormonal contraception ≥5 years (ORa=3.5), history of sexually transmitted infections (STIs; ORa=2.3), low education (ORa=2.1) and smoking (ORa=1.8). HPV vaccination coverage was 7%, screening coverage 0.43%, and 60% of screen-positive women were treated (performance score: 3/10). Multiple risk factors and major prevention gaps were identified. Strengthening HPV vaccination, screening and timely treatment is essential.