PloS one · 2026
Cervical leukoplakia in Ghana: Unveiling diagnostic challenges and informing low-resource screening strategies.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Effah Kofi, Tekpor Ethel, Afetor Maxwell, Amuah Joseph Emmanuel, Wormenor Comfort Mawusi, Dugbazah Annita Edinam, Danyo Stephen, Kemawor Seyram, Sesenu Edna, Nyamekye Christopher, Donkoh Emmanuel Timmy, Kubio Chrysantus, Adum-Attah Kofi
Аннотация
BACKGROUND: Visual Inspection with Acetic acid (VIA) is widely used for detecting cervical (pre)cancer in resource-limited settings due to its simplicity and cost-effectiveness. However, the finding of cervical leukoplakia, poses diagnostic challenges.
METHODS: This retrospective observational study evaluated the prevalence, associated risk factors, and referral outcomes of cervical leukoplakia among 13,861 women previously screened for cervical cancer in Ghana between June 2016 and May 2024. Screening approaches included VIA alone, mobile colposcopy alone, or VIA/mobile colposcopy combined with other tests (HPV DNA testing and/or cytology).
RESULTS: Among 120 women (0.9%) with leukoplakia, 112 (93.3%) did not have acetowhitening on VIA/mobile colposcopy, and 21 (17.5%) received LEEP. The histopathology results ranged from no Cervical Intraepithelial Neoplasia (CIN) (15) to CIN I (2), CIN II (1), and CIN III (3). High-risk HPV positivity (aOR: 30.27; 95% CI: 3.56-257.37) and HIV infection (aOR: 8.27; 95% CI: 1.18-57.69) were associated with higher odds of leukoplakia in VIA-screened women.
CONCLUSION: Leukoplakia can be clinically important without coexistence with acetowhitening. The association of leukoplakia with hrHPV and HIV, coupled with a high referral default and logistical barriers to biopsy and histopathology, calls for simplified management protocols and point-of-care triage tools for cervical screening in low-resource settings.
METHODS: This retrospective observational study evaluated the prevalence, associated risk factors, and referral outcomes of cervical leukoplakia among 13,861 women previously screened for cervical cancer in Ghana between June 2016 and May 2024. Screening approaches included VIA alone, mobile colposcopy alone, or VIA/mobile colposcopy combined with other tests (HPV DNA testing and/or cytology).
RESULTS: Among 120 women (0.9%) with leukoplakia, 112 (93.3%) did not have acetowhitening on VIA/mobile colposcopy, and 21 (17.5%) received LEEP. The histopathology results ranged from no Cervical Intraepithelial Neoplasia (CIN) (15) to CIN I (2), CIN II (1), and CIN III (3). High-risk HPV positivity (aOR: 30.27; 95% CI: 3.56-257.37) and HIV infection (aOR: 8.27; 95% CI: 1.18-57.69) were associated with higher odds of leukoplakia in VIA-screened women.
CONCLUSION: Leukoplakia can be clinically important without coexistence with acetowhitening. The association of leukoplakia with hrHPV and HIV, coupled with a high referral default and logistical barriers to biopsy and histopathology, calls for simplified management protocols and point-of-care triage tools for cervical screening in low-resource settings.