The Association between Cervical Cancer Screening and Invasive Cervical Cancer in Ekurhuleni District, South Africa: 2005–2021
1
National Cancer Registry, National Health Laboratory Services, Johannesburg, South Africa
2
Epidemiology & Biostatistics, University of the Witwatersrand, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Cervical cancer (CC) is the leading cause of cancer-related mortality in women in South Africa (SA)1. Organised cervical cancer screening (CCS) is crucial in early detection of CC2. This study aimed to investigate the association between CCS and invasive CC.
METHODS:
A case-control study was conducted among women age 15 years and older, who resided in Ekurhuleni, Gauteng, South Africa, from 2005-2021. Incident cancer cases from the Ekurhuleni Population-Based Cancer Registry were linked to CCS data using STATA. Unconditional multivariable logistic regression was used to estimate adjusted odds ratios (AOR) of CCS status as the primary exposure and CC as the primary outcome. Other predictors included age groups. HIV status, and race.
RESULTS:
Among 10,027 participants included in the study; 49.2% (4,931) were controls and 50.8% (5,096) were cases. The overall median age was 48 years (IQR: 40-58), while it was 50 years (IQR: 41-61) for controls, and 47 years (IQR: 40-55) for cases. Approximately 56.8% (5,697) of the women did not undergo CCS, while 43.2% (4,330 ) underwent CCS. It was found that CCS was positively associated with CC (AOR: 1.48, CI: 1.35-1.63, p < 0.001). Additionally, other factors found to be positively associated with CC included living with HIV (LWH) (AOR: 1.53, p < 0.001), being black (AOR: 3.0, p < 0.001) or coloured (AOR: 2.14, p < 0.001), being aged between 30-59 (p < 0.001), and older than 60 years (p = 0.003).
CONCLUSIONS:
Strengthening and optimisation of organised CCS screening programmes for black and coloured women, women LWH, middle-aged, and older women due to increased risk is instrumental for the control of CC. Consistent evaluation of CCS programmes is necessary to address gaps, track progress, and ensure sustainability. Further research is required to explore fundamental reasons for the positive association between CCS and CC.
Cervical cancer (CC) is the leading cause of cancer-related mortality in women in South Africa (SA)1. Organised cervical cancer screening (CCS) is crucial in early detection of CC2. This study aimed to investigate the association between CCS and invasive CC.
METHODS:
A case-control study was conducted among women age 15 years and older, who resided in Ekurhuleni, Gauteng, South Africa, from 2005-2021. Incident cancer cases from the Ekurhuleni Population-Based Cancer Registry were linked to CCS data using STATA. Unconditional multivariable logistic regression was used to estimate adjusted odds ratios (AOR) of CCS status as the primary exposure and CC as the primary outcome. Other predictors included age groups. HIV status, and race.
RESULTS:
Among 10,027 participants included in the study; 49.2% (4,931) were controls and 50.8% (5,096) were cases. The overall median age was 48 years (IQR: 40-58), while it was 50 years (IQR: 41-61) for controls, and 47 years (IQR: 40-55) for cases. Approximately 56.8% (5,697) of the women did not undergo CCS, while 43.2% (4,330 ) underwent CCS. It was found that CCS was positively associated with CC (AOR: 1.48, CI: 1.35-1.63, p < 0.001). Additionally, other factors found to be positively associated with CC included living with HIV (LWH) (AOR: 1.53, p < 0.001), being black (AOR: 3.0, p < 0.001) or coloured (AOR: 2.14, p < 0.001), being aged between 30-59 (p < 0.001), and older than 60 years (p = 0.003).
CONCLUSIONS:
Strengthening and optimisation of organised CCS screening programmes for black and coloured women, women LWH, middle-aged, and older women due to increased risk is instrumental for the control of CC. Consistent evaluation of CCS programmes is necessary to address gaps, track progress, and ensure sustainability. Further research is required to explore fundamental reasons for the positive association between CCS and CC.
| eISSN: | 2654-1459 |
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