411 Cervical cancer management in a low resource setting: a 10-year review in a tertiary care hospital in Kenya

Abstract

<h3>Introduction/Background</h3> Cervical cancer is one of the leading causes of cancer mortality among women in Kenya due to late presentations, poor access to health care, and limited resources. Across many low- and middle-income countries infrastructure and human resources for cervical cancer management are currently insufficient to meet the high population needs therefore patients are not able to get appropriate treatment. This study aimed to describe the clinicopathological characteristics and the treatment profiles of cervical cancer cases seen at Moi Teaching and Referral Hospital (MTRH), contributing to an improved understanding of the treatment landscape that has evolved over the past decade. This will help identify the existing gaps in care in a low-resource setting over the last decade and their global implications. <h3>Methodology</h3> This was a retrospective cross-sectional study conducted at MTRH involving the review of the electronic database and medical files of 1541 patients with a histologically confirmed diagnosis of cervical cancer between January 2012 and December 2021. <h3>Results</h3> Of the 1541 cases analyzed, 91% were squamous cell carcinomas, 8% were adenocarcinomas, and 1% were other histological types. Thirty-eight percent of the patients were HIV infected and less than 30% of the women had health insurance. A majority (75%) of the patients presented with advanced-stage disease (stage IIB-IV). Only 13.9% received chemoradiotherapy with curative intent; of which 34% received suboptimal treatment. Of the 13% who received surgical treatment, 45.3% required adjuvant therapy, of which only 27.5% received treatment. Forty percent of the women were lost to follow-up. <h3>Conclusion</h3> Most of the cervical cancer patients in Kenya present at advanced stages with only a third receiving the necessary treatment while the majority receive only palliative treatment or supportive care. <h3>Disclosures</h3> None.