Female genital mutilation and noninvasive cervical abnormalities and invasive cervical cancer in Senegal, West Africa: A retrospective study. Issue 6 (31st October 2018)

• Record Type: Journal Article
• Authors: Osterman, Allison L.; Winer, Rachel L.; Gottlieb, Geoffrey S.; Sy, Marie‐Pierre; Ba, Selly; Dembele, Birama; Toure, Papa; Dem, Ahmadou; Seydi, Moussa; Sall, Fatima; Sow, Papa Salif; Kiviat, Nancy B.; Hawes, Stephen E.
• Is Part Of: International journal of cancer. Volume 144:Issue 6(2019)
• Page Start: 1302
• Page End: 1312
• Publication Date: 2018-10-31
• Subjects: cervical cancer -- female genital mutilation -- sub‐Saharan Africa -- Senegal; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.31829
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Female genital mutilation or cutting (FGM/C) is a traditional practice that affects a significant portion of women in sub‐Saharan Africa, Egypt, areas of the Middle East and some countries in Asia. While clinical and epidemiological studies have established a close association between inflammation and carcinogenesis, particularly in epithelial cancers, the relationship between FGM/C and cervical cancer is not well known. We performed a secondary analysis using combined data from six research studies conducted in and around Dakar, Senegal from 1994 to 2012. Study subjects included both asymptomatic women who presented to outpatient clinics but were screened for cervical cancer, and women with cancer symptoms who were referred for cervical cancer treatment. We used unconditional logistic regression to estimate adjusted pooled odds ratios (ORs) and 95% confidence intervals (CI) for associations between FGM/C and (1) Invasive cervical cancer (ICC) and (2) noninvasive cervical abnormalities. After adjusting for confounding, women with ICC were 2.50 times more likely to have undergone FGM/C than women without cervical abnormalities (95% CI, 1.28–4.91). Restricting to HPV‐positive women increased the strength of the association (OR = 4.23; 95% CI 1.73–10.32). No significant associations between FGM/C and noninvasive cervical abnormalities were observed, except in commercial sex workers with FGM/C (OR = 2.01; 95% CI 1.19–3.40). The potential increased risk for ICC suggested by our study warrants further examination. Study results may impact cancer prevention efforts in populations where FGM/C is practiced and draw awareness to the additional health risks associated with FGM/C. Abstract : What's new? Female genital mutilation or cutting, a practice that affects an estimated 200 million women and girls worldwide, is an understudied risk factor for cervical cancer, the most common cancer among women in Africa. Here the authors present evidence that genital mutilation or cutting increases cervical cancer risk, especially in women infected with human papillomavirus. This may impact cancer prevention efforts in populations where mutilation is practiced frequently and should draw awareness to the additional health risks associated with the practice.