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Introduction: Cervical cancer is the second most common female cancer in Ghana. The disease and its treatment significantly affect survivors' health-related quality of life (HRQoL). We determined the overall quality of life (QoL) and identified its predictors among cervical cancer survivors after treatment. Materials and methods: A hospital-based cross-sectional analytical study was conducted on 153 disease-free cervical cancer survivors who completed curative treatment between January 2004 and December 2018 at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. We used the European Organization for Research and Treatment of Cancer core-30 item (EORTC QLQ-C30) and cervical cancer module (EORTC QLQ-CX24) to assess the survivors' overall QoL. QoL domain scores were dichotomised as affected or unaffected by disease and its treatment. Significant differences between the affected and unaffected groups within each QoL domain were determined using the student T-test. We used Kruskal-Wallis and Dunn's tests to examine the difference in QoL domains between treatment types, with significance based on Bonferroni corrections. Multivariable logistic regression was performed to identify predictors of overall QoL. A p-value of less than 0.05 was considered statistically significant. Results: One hundred and fifty-three (153) women having a mean age of 58.3 (SD 11.4) years were studied. The overall QoL score was 79.6 (SD 16.0), and 74.5% of survivors reported good QoL score within the median follow up time of 41.8 months (interquartile range [IQR], 25.5–71.1 months) after cervical cancer diagnosis. Although the majority (66.0–84.3%) of the QoL functioning scale were unaffected, about a fifth (22.2%) to a third (34.5%) of the subjects had perceptual impairment in cognitive and role functioning. Financial difficulties, peripheral neuropathy and pain were most common symptoms reported as affected. A third of the survivors were worried that sex would be painful, and 36.6% indicated that their sexual activity as affected. The overall QoL scores for survivors who had surgery, chemoradiation and radiation-alone were 86.1 (SD 9.7), 76.9 (SD 17.7), and 80.7 (SD 14.7), respectively (p = 0.025). The predictors of survivor's overall QoL were loss of appetite [Adjusted Odd Ratio (AOR) = 9.34, 95% Confidence Interval (CI) = 2.13–35.8, p = 0.001], pain (AOR = 3.53, 95% CI = 1.25–9.31, p = 0.017) and body image (AOR = 5.89, 95% CI = 1.80–19.27, p = 0.003). Conclusion: About 75% of the survivors had a good overall quality of life. Primary surgical treatment affords the best prospects for quality of life with the least symptom complaints and financial burden. Loss of appetite, pain or diminution in body image perception predicted the overall quality of life of cervical cancer survivors after treatment. [ABSTRACT FROM AUTHOR]

Objective: To explore factors associated with late clinical presentation among Ghanaian women with cervical cancer Design: This is a cross-sectional survey using a paper questionnaire. Setting: Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. Participants: Participants were women presenting for cervical cancer care at KATH. Inclusion criteria were histologically diagnosed cervical cancer and age ≥18 years. The exclusion criteria was age <18. All women presenting from August 2018-August 2019 were recruited. Main outcome measures: The primary outcome was the proportion of participants presenting with late-stage cervical cancer, defined as stage II or higher. Results: Of 351 total participants, 33.6% were unemployed, 35.3% had no formal education, and 96.6% had an average monthly income of less than five hundred Ghana cedis ($86 USD). Time from symptoms to seeing a doctor ranged from fewer than two weeks (16.0%) to more than twelve months (8.6%). Participants' most common barrier in seeking healthcare was financial constraints (50.0%). Most participants presented at late-stage cervical cancer (95.2%, n=334), with only 4.8% (n=17) presenting at stage I. Of participants presenting with late-stage cervical cancer, the vast majority had never had a Papanicolaou (Pap) smear (99.1%) nor a recent gynecologic exam (99.3%). After adjusting for age, parity, and distance to a healthcare facility, a late-stage presentation was associated with lower income and living in a rural area. Conclusions: In Ghana, 95% of women with cervical cancer seek care at a late clinical stage, defined as stage II or greater, when the cancer is inoperable. [ABSTRACT FROM AUTHOR]

Each year, cervical cancer causes the death of over 275,000 women worldwide with eighty percent of these cases occurring in low or lower-middle income countries. Cervical cancer screening programs reduce cervical cancer occurrence by identifying and treating pre-cancerous cervical abnormalities before they develop to malignant stages. Standard methods of screening are inappropriate for use in low-resource settings and therefore screening is very limited. Based on a design ethnography study performed over a two-month period in Ghana, a need was identified for a low-fidelity model to assist in training healthcare providers to screen for cervical cancer using visual inspection with acetic acid. The design presented in this paper is a box trainer with a simulated vaginal cavity that allows a user to insert cervical images displayed on plastic tabs or cards from the Jhpiego Visual Inspection of the Cervix Flash Card Set. A modular electronic feedback mechanism trains the user to properly complete the steps of the screening procedure and to track the successes of their diagnoses. This paper describes the need for a cervical cancer screening trainer, the process used to design a trainer to support visual inspection with acetic acid, and the results of prototyping and preliminary usability tests. [ABSTRACT FROM AUTHOR]

Background/Aims: A phase II study was conducted to assess the activity and toxicity of weekly docetaxel in patients with advanced or recurrent cancer of the cervix. Methods: Eligible patients were required to have measurable disease with adequate performance status, bone marrow, renal and hepatic function. Patients were allowed to receive chemosensitization and not more than one prior chemotherapy regimen excluding taxanes. Docetaxel 35 mg/m2 was administered intravenously weekly for 3 weeks followed by 1 week off until disease progression or adverse effects prohibited further therapy. Results: Ten patients were entered into this study, all of who were evaluable for toxicity and response. A median of 2 cycles (range 2–6) were administered. The most frequent drug-related toxicities were anemia and fatigue. There were no objective responses. Three patients had stable disease up to 6 cycles. One patient died of exsanguination from a known vaginal metastasis after completing her second cycle. The median progression-free interval was 1.7 months (range 0.9–5.8) and overall survival was 6.9 months (1.6–23.7). Conclusions: Docetaxel has limited activity in patients with recurrent cancer of the cervix at the dose and schedule tested. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: Cervical cancer can be prevented by regular screening; however, screening rates are low in developing countries. We evaluated the proportion of women screened, modalities of screening utilized, and factors influencing uptake among Ghanaian women with access to free screening services. Methods: Participants were women aged 25–65 in Asokore‐Mampong, Ghana. A structured questionnaire collected socio‐demographic characteristics, risk factors, knowledge of, and utilization of cervical cancer screening. Adjusted logistic regression evaluated predictors of screening. Results: Of 710 participants, the majority had heard of cervical cancer (64.6%) and screening (57.7%). Screening utilization was 24.6%. Visual inspection with acetic acid was the most common screening method (97.1%). For those who had never been screened, common reasons were believing they were healthy (21.7%), fearing pain (12.9%), lacking awareness of screening (11.8%), and being too busy (11.6%). Participants who were aged 35–44 (aOR 1.82; 95% CI 1.09–3.03; p = 0.023), married (aOR 3.98; 95% CI 1.68–9.40; p = 0.002), formally employed (aOR 9.31; 95% CI 2.86–30.35; p <0.001), and had higher cervical cancer knowledge (aOR 3.98; 95% CI 2.64–6.02; p <0.001) were more likely to have been screened. Conclusion: Despite geographic proximity to a health center that provides free cervical cancer screening, screening uptake among Ghanaian women remains low. Synopsis: The contents of this page will be used as part of issue TOC only. It will not be published as part of main article. In Ghana, despite geographic proximity to a health center that provides free cervical cancer screening, screening uptake among Ghanaian women remains low. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to determine whether positron emission tomography (PET) using F-18-fluorodeoxyglucose (FDG) before and after radiotherapy would predict whether local control of cervical cancer had been achieved.Methods. FDG-PET scans were performed prior to therapy and at a mean of 4.6 months after radiation in 20 patients (pts) with histologically proven uterine cervical cancer who were undergoing a “curative” course of radiation therapy. FDG uptake was interpreted visually by two readers using a 5-point grading system (0 = normal, 1 = probably normal, 2 = equivocal, 3 = probably abnormal, and 4 = definitely abnormal). The standardized uptake values corrected by lean body mass (SUL) were calculated for suspicious areas. The percentage of residual activity (%RA) for the posttherapy SUL was also evaluated as a percentage of the pretherapy SUL.Results. At baseline before irradiation, 17 of 20 (85.0%) primary tumors were detected. Following irradiation, no or low (grade 0–2) uptake was observed in 9 pts, and none of these had local recurrence. Among the remaining 11 pts with grade 3 or 4 uptake, the correct diagnosis was made for 5 pts with active tumor; SULs (mean ± SD = 4.17 ± 2.52) and %RAs (57.9 ± 16.8). Six patients without active tumor showed relatively low SULs (2.67 ± 0.69) and %RAs (43.0 ± 18.3). No significant differences were observed between the recurrent and nonrecurrent groups for these parameters. Overall, sensitivity, specificity, and accuracy were 100, 60, and 70%, respectively.Conclusion. These preliminary data indicate that FDG-PET is a sensitive tool for detecting active cervical cancer after radiation, however, the method, without anatomic correlation had suboptimal specificity. [Copyright &y& Elsevier]