Precancerous lesion determinants in women attending cervical cancer screening at public health facilities in North Shoa Zone, Amhara, Ethiopia - an unmatched case-control study

Q: What is the main goal of the study?

To identify determinants, or risk factors, associated with cervical precancerous lesions among women screened for cervical cancer at public health facilities in North Shoa Zone, Amhara, Ethiopia.

Q: What study design and population were used?

An unmatched case-control study conducted from January to April 2020, including 216 women aged 30–49: 54 VIA-positive cases and 162 VIA-negative controls.

Q: Which factors were linked to higher odds of precancerous cervical lesions?

Using oral contraceptives for more than five years, early sexual debut (below age 15), and a history of STIs including HIV were associated with higher odds in multivariable analysis.

Sep 21, 2026

Uploaded by Emma Wilson

Cervical precancerous lesions arise in the transformation zone and progress through CIN 1, 2, and 3, with CIN2/CIN3 potentially leading to cervical cancer if untreated. Determinants in Ethiopia remain insufficiently documented. This study identifies risk factors for cervical precancerous lesions among women undergoing screening at public health facilities in North Shoa Zone, Amhara, Ethiopia. A January–April 2020 unmatched case-control design compared VIA-positive cases and VIA-negative controls aged 30–49, using multivariable logistic regression.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Background

Role of precancerous lesions and CIN

Prevention and HPV vaccination context

HPV and global cervical cancer burden

Teklehaimanot etal. BMC Women's Health (2024) 24:271 BMC Women's Health [https://doi.org/10.1186/s12905-024-03113-z](https://doi.org/10.1186/s12905-024-03113-z) RESEARCH Open Access Precancerous lesion determinants in women attending cervical cancer screening at public health facilities in North Shoa Zone, Amhara, Ethiopia: an unmatched case-control study Dereje Abebe Teklehaimanot 1, Abinet Dagnaw Mekuria2, Abel Fekadu Dadi3,4 and Behail uTariku Derseh2,4* Abstract Background Precancerous cervical lesions develop in the transformation zone of the cervix and progress through stages known as cervical intraepithelial neoplasia (CIN) 1, 2, and 3. If untreated, CIN2 or CIN3 can lead to cervical cancer. The determinants of cervical precancerous lesions are not well documented in Ethiopia. Therefore, this study aims to find the determinants of cervical precancerous lesions among women screened for cervical cancer at public health facilities. Methods A study conducted from January to April 2020 involved 216 women, consisting of 54 cases (positive for VIA during cervical cancer screening) and 162 controls (negative for VIA) . It focused on women aged 30 to 49 undergoing cervical cancer screening. Multivariable logistic regression analysis assessed the link between precancerous lesions and different risk factors, considering a significance level of p < 0.05. Results Women who used oral contraceptives for a duration exceeding five years showed a nearly fivefold increase in the likelihood of developing precancerous lesions (Adjusted Odds Ratio (AOR) = 4 . 75; 95% CI: 1.48, 15. 30) . Additionally, early age at first sexual intercourse (below 15 years) elevated the odds of developing precancerous lesions fourfold (AOR = 3 . 77; 95% CI: 1.46, 9 . 69) . Furthermore, women with HIV seropositive results and a prior history of sexually transmitted infections (STIs) had 3.4 times (AOR = 3 .45; 95% CI: 1. 29, 9 . 25) and 2.5 times (AOR = 2 . 58; 95% CI: 1. 10, 6 . 09) higher odds of developing cervical precancerous lesions compared to their counterparts. Conclusion In conclusion, women who have used oral contraceptives for over five years, started sexual activity before the age of 15 and have a history of sexually transmitted infections, including HIV, are at higher risk of developing precancerous cervical lesions. Targeted intervention strategies aimed at promoting behavioural change to prevent early sexual activity and STIs are crucial for avoiding cervical precancerous lesions. It is crucial to introduce lifecourse principles for female adolescents early on, acknowledging the potential to prevent and control precancerous lesions at critical stages in life, from early adolescence to adulthood, encompassing all developmental phases. Keywords Pre-cancerous lesions, Sexually transmitted diseases, Oral contraceptives *Correspondence: Behail uTariku Derseh [minastariku@gmail.com](minastariku@gmail.com) 1Debre Berhan Comprehensive Specialized Hospital, Debre Berhan, Ethiopia 2Department of Public Health, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Ethiopia 3Addis Continental Institute of Public Health, Addis Ababa, Ethiopia 4Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or e

FAQs

What is the main goal of the study?

To identify determinants, or risk factors, associated with cervical precancerous lesions among women screened for cervical cancer at public health facilities in North Shoa Zone, Amhara, Ethiopia.

What study design and population were used?

An unmatched case-control study conducted from January to April 2020, including 216 women aged 30–49: 54 VIA-positive cases and 162 VIA-negative controls.

Which factors were linked to higher odds of precancerous cervical lesions?

Using oral contraceptives for more than five years, early sexual debut (below age 15), and a history of STIs including HIV were associated with higher odds in multivariable analysis.

Sep 21, 2026

Uploaded by Emma Wilson