Histological Characterization of Invasive Cervical Cancer and Precursor Lesions in Malawian Women Presenting at Queen Elizabeth Central Hospital (QECH): A Cross-Sectional Study

Background: Cervical cancer is part of the huge burden of diseases in developing countries and is the second most common cancer in women worldwide. In Malawi, cervical cancer ranks as the first most frequent cancer in women between 15 and 64 years of age. We aimed at providing data about the distribution of different histological types of cervical cancer and precancerous lesions in patients presenting at Queen Elizabeth Central Hospital (QECH) in Malawi.

Methods: A total of 212 patient samples collected from 1st January, 2014 through 31st December, 2014 were included in the study. Tissue Hematoxylin and Eosin staining technique for microscopic histopathological classification of cervical lesions was used. Data was analyzed using IBM SPSS® version 20.0 for windows. The chisquare and Multinomial logistic regression test with a p-value of less than 0.05 was used to indicate statistical significance of the results.

Results: Out of 212 cases having precancerous lesions and cervical cancer that were included in the study, cervical lesions comprised 17% (35/212) pre-cancerous lesions, 65% (137/212) cancerous and 18% (39/212) had both pre-cancerous and cervical cancer, making a total of 176 (83%) cancer lesions. The most common cervical lesion was squamous cell carcinoma (SCC) with 72 % (151/212) cases.

Conclusion: Invasive SCC was found to be the commonest type of cervical cancer and high grade squamous intraepithelial lesions (HSIL) the commonest pre-cancerous lesion among women