Pathology findings among women with alterations in uterine bleeding patterns in cameroon

Simon M Manga; Yuanfan Ye; Jeff M Szychowski; Kathleen L Nulah; Calvin Ngalla; Kaitlyn Kincaid; Teresa K L Boitano; Alan T Tita; Isabel Scarinci; Warner K Huh; Zacharie Sando; Margaret I Liang

doi:10.1016/j.gore.2021.100821

Pathology findings among women with alterations in uterine bleeding patterns in cameroon

Gynecol Oncol Rep. 2021 Jun 24:37:100821. doi: 10.1016/j.gore.2021.100821. eCollection 2021 Aug.

Authors

Simon M Manga^{1

2}, Yuanfan Ye², Jeff M Szychowski², Kathleen L Nulah¹, Calvin Ngalla¹, Kaitlyn Kincaid³, Teresa K L Boitano³, Alan T Tita^{2

3}, Isabel Scarinci⁴, Warner K Huh^{2

5}, Zacharie Sando⁶, Margaret I Liang^{2

5}

Affiliations

¹ Women's Health Program, Cameroon Baptist Convention Health Services, Bamenda, P.O. Box 1, Nkwen, Bamenda, Cameroon.
² Center for Women's Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA.
³ Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6 Avenue South, Suite 10360, Birmingham, AL 35233, USA.
⁴ Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, MT Birmingham, AL 35233, USA.
⁵ Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite10250, Birmingham, AL 35233, USA.
⁶ Department of Pathology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, P.O. Box 1364, Yaoundé, Cameroon.

Abstract

Purpose: Endometrial cancer is on the rise in high-income countries but it has not been adequately studied in low-and-middle income countries especially in sub-Saharan Africa (SSA), likely due to scarce pathology facilities. The purpose of this study was to characterize and quantify the prevalence of endometrial hyperplasia or cancer in a cohort of women with abnormal uterine bleeding (AUB) who underwent endometrial biopsy in Cameroon.

Methods: We designed a cross-sectional study using medical records to characterize women who underwent endometrial biopsy in the Cameroon Baptist Convention Health Services (CBCHS) from 2008 to 2019. Pathologic diagnoses were classified as either endometrial hyperplasia, endometrial cancer, or no endometrial hyperplasia/cancer. We reported the overall prevalence of endometrial hyperplasia or cancer. Bivariate analyses compared patient characteristics between women with endometrial cancer, endometrial hyperplasia, and neither.

Results: The average age was 46.2 years and women had an average of 5.1 parity. We found that, 61 [(36.7% of 166 women; 95% CI (27.6-47.0%)] had endometrial hyperplasia or cancer. There were no cases of hyperplasia with atypia and 13 women had endometrial cancer. The remainder were comprised of benign or infectious pathologic findings. In bivariate analysis, mean ages were statistically different among the three groups (hyperplasia, cancer, and no hyperplasia/cancer), p < 0.001, and women with cancer had the highest age. Parity was statistically significantly different among the three groups (p = 0.002) and women with endometrial cancer had higher parity.

Conclusion: We found that just over 1 in 3 women with AUB who underwent endometrial biopsy at a health system in SSA were found to have pathologic findings of endometrial hyperplasia or cancer, with no cases of hyperplasia with atypia. Women with endometrial cancer had higher mean age and parity.

Keywords: Cameroon; Endometrial cancer; Endometrial hyperplasia.

Publication types

Case Reports