Objective: To determine the pattern of clinical presentations of cases of clinically diagnosed cancer of the cervix at the Federal Teaching Hospital Gombe.

Method: It was a retrospective study over a ten year period.

Results: There were 8075 Gynaecological admissions in the study period and 302 were Gynaecological malignancies, 176 cases were identified but only 116 folders were available for review. Hence cervical cancer made up 0.022% and 58.3% of all Gynaecological admissions and Gynaecological Malignancy admissions respectively. The mean ages was 53.5years +11.8, the peak incidence occurring at age range of 41-50 years. The highest incidence occurs among those with parity 5 and above (105/90.5%). The commonest presentation was abnormal vaginal bleeding 100(86.2%). Most of the patients presented with advanced disease (FIGO Stage IIB-IV). Squamous cell carcinoma accounted for 105(90.5%).

Keywords: Cervical cancer, presentation, clinico-pathological.

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2. World Health Organization (WHO). World Cancer Report. 2014; 5-12.
3. Ferlay J, Shin HR, Bray F. GLOBOCAN 2008. Cancer Incidence and Mortality Worldwide: IARC Cancer Base No 10, Lyon France. International Agency for Research on Cancer, 2010. Available at http://www.globocan.iarc.fr.   Accessed on 12 Apr, 2015.
4. Quinn M, Babb P, Jones J, Allen E. Effect of screening on incidence of and mortality from cancer of cervix in England: Evaluation based on routinely collected statistics. BMJ 1999;318-904.
5. Kwame-Aryee R. Carcinoma of Cervix In: Kwawukume EY, Emuveyan EE (Eds) Comprehensive Gynaecology in the tropics. 1^st ed, Accra. Graphic Packaging Limited. 2005; 412-428.
6. Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron W, et al. SEER Cancer Statistics Review 1975-2009. Available at www.seer.cancer.gov/csr. Accessed on 9 Sept; 2015.
7. Ijaiya MA, Aboyeji AP, Olatinwo AWO, Buhari MO. Clinicopathological presentation of primary cervical cancer seen in Ilorin,Nigeria. Niger J Surg Res 2002; 4:89-92.
8. Ikechebelu JI, Onyiaorah IV, Ugboaja JO, Anyiam DC, Eleju GU. Clinicopathological analysis of cervical cancer seen in a tertiary health facility in Nnewi, South-east Nigeria. J Obstet Gynaecol. 2010 Apr;30(3):299-301
9. Mushosho EY, Ndolovu N, Eugel-Hills P, Wyrley-Birch B. Presentation patterns of invasive cancer of the cervix: results from Parirenyatwa Oncology and Radiotherapy Centre, Harare, Zimbabwe 1998-2010. Central Afri J Med. 2011;57(9-12):43-9
10. Rogo KO, Omany J, Onyango JN, Ojwang SB, Stendahl U. Carcinoma of the cervix in the African Setting. Int J Gynecol Obstet 1990;33:249-255
11. Adewole IF. Epidemiology, clinical features and management of cervical cancer In: Okonofua F and Odunsi K(eds). Contemporary Obstetrics and Gynaecology for the developing countries. 1^st ed, Benin city. Women Health and Action Research Centre.2003; 289-315.
12. Eide TJ. Cancer of the uterine cervix in Norway by Histologic Type. J Natl Cancer Inst 1987; 79(2):199-205.
13. Abu-Rustum NR, Sonoda Y: Fertility-sparing in early stage of cervical cancer. Indications and applications. J Natl Compr Canc Netw 2010; 8(12):1435-8.
14. Ho CM, Chien TY, Jeng CM, Tsang YM, Shih BY, Chang SO. Staging of cervical cancer: Comparison between magnetic resonance imaging, computed tomography and pelvic examination under anesthesia.  J Formos Med Assoc. 1992;91(10):982-90
15. Dhoot NM, Kumar V, Shinagare A, Kataki AC, Barmon D, Bhuyan U. Evaluation of carcinoma cervix using magnetic resonance imaging: correlation with clinical FIGO staging and impact on management. J Med Imaging Radiat Oncol. 2012; 56(1):58-65.
16. Smith HO, Tiffany MF, Qualls CR, Key CR. The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States: a 24-year population-based study. Gynecol Oncol. 2000;78(2):97-105.
17. Bray F, Carstensen B, Moller B, Zappa M, Zakelj MP, Lawrence G, et al. Incidence trends of adenocarcinoma of the cervix in 13 European countries. Epidemiol Biomarkers Prev. 2005;14(9):2191-9
18. Udigwe GO, Ogabido CA: A clinic-pathological study of cervical carcinoma in South Eastern, Nigeria a five year retrospective study. Niger J.Clin Pract 2008 Sep ll (3): 202-5
19. Uzoigwe SA, Seleye–Fabara D. Cancers of the uterine cervix in Port Harcourt, Rivers State, a 3 year clinic-pathological Nig. J. Med. 2004; (312):110 -3.
20. Anorlu RT. Orakwue CO, Oyeneyin L, Asdidu OO. Late presentation of patients with cervical cancer to a Tertiary Hospital in Lagos. What is responsible? Euro J Gynaecol oncology 2004; 25 (6): 729 32.
21. Udigwe GO. Knowledge, attitude and practice of cervical cancer screening. (Pap smear) among females nurses in Nnewi, South Eastern Nigeria. Nigerian J. Clin Practice 2006; 9(1):40, 43.
22. Moodley M. Mould S. Invasive cervical cancer and Human Immunodeficiency virus (HIV) infections in Kwazulu. Natal South Africa. J Obstract Gynaecol 2008. 25(7): 706.10.
23. Anorlu RI. Tumour of the cervix uteri: In  Agboola A(ed) Textbooks of Obstetrics and Gynaecology for Medical Students. 2^nd ed, Ibadan. Heineman Education Books (Nigeria). 2006;167-83.
24. World Health Organization (WHO). World Cancer Report. 2014; 5-12.
25. Ferlay J, Shin HR, Bray F. GLOBOCAN 2008. Cancer Incidence and Mortality Worldwide: IARC Cancer Base No 10, Lyon France. International Agency for Research on Cancer, 2010. Available at http://www.globocan.iarc.fr.   Accessed on 12 Apr, 2015.
26. Quinn M, Babb P, Jones J, Allen E. Effect of screening on incidence of and mortality from cancer of cervix in England: Evaluation based on routinely collected statistics. BMJ 1999;318-904.
27. Kwame-Aryee R. Carcinoma of Cervix In: Kwawukume EY, Emuveyan EE (Eds) Comprehensive Gynaecology in the tropics. 1^st ed, Accra. Graphic Packaging Limited. 2005; 412-428.
28. Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron W, et al. SEER Cancer Statistics Review 1975-2009. Available at www.seer.cancer.gov/csr. Accessed on 9 Sept; 2015.
29. Ijaiya MA, Aboyeji AP, Olatinwo AWO, Buhari MO. Clinicopathological presentation of primary cervical cancer seen in Ilorin,Nigeria. Niger J Surg Res 2002; 4:89-92.
30. Ikechebelu JI, Onyiaorah IV, Ugboaja JO, Anyiam DC, Eleju GU. Clinicopathological analysis of cervical cancer seen in a tertiary health facility in Nnewi, South-east Nigeria. J Obstet Gynaecol. 2010 Apr;30(3):299-301
31. Mushosho EY, Ndolovu N, Eugel-Hills P, Wyrley-Birch B. Presentation patterns of invasive cancer of the cervix: results from Parirenyatwa Oncology and Radiotherapy Centre, Harare, Zimbabwe 1998-2010. Central Afri J Med. 2011;57(9-12):43-9
32. Rogo KO, Omany J, Onyango JN, Ojwang SB, Stendahl U. Carcinoma of the cervix in the African Setting. Int J Gynecol Obstet 1990;33:249-255
33. Adewole IF. Epidemiology, clinical features and management of cervical cancer In: Okonofua F and Odunsi K(eds). Contemporary Obstetrics and Gynaecology for the developing countries. 1^st ed, Benin city. Women Health and Action Research Centre.2003; 289-315.
34. Eide TJ. Cancer of the uterine cervix in Norway by Histologic Type. J Natl Cancer Inst 1987; 79(2):199-205.
35. Abu-Rustum NR, Sonoda Y: Fertility-sparing in early stage of cervical cancer. Indications and applications. J Natl Compr Canc Netw 2010; 8(12):1435-8.
36. Ho CM, Chien TY, Jeng CM, Tsang YM, Shih BY, Chang SO. Staging of cervical cancer: Comparison between magnetic resonance imaging, computed tomography and pelvic examination under anesthesia.  J Formos Med Assoc. 1992;91(10):982-90
37. Dhoot NM, Kumar V, Shinagare A, Kataki AC, Barmon D, Bhuyan U. Evaluation of carcinoma cervix using magnetic resonance imaging: correlation with clinical FIGO staging and impact on management. J Med Imaging Radiat Oncol. 2012; 56(1):58-65.
38. Smith HO, Tiffany MF, Qualls CR, Key CR. The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States: a 24-year population-based study. Gynecol Oncol. 2000;78(2):97-105.
39. Bray F, Carstensen B, Moller B, Zappa M, Zakelj MP, Lawrence G, et al. Incidence trends of adenocarcinoma of the cervix in 13 European countries. Epidemiol Biomarkers Prev. 2005;14(9):2191-9
40. Udigwe GO, Ogabido CA: A clinic-pathological study of cervical carcinoma in South Eastern, Nigeria a five year retrospective study. Niger J.Clin Pract 2008 Sep ll (3): 202-5
41. Uzoigwe SA, Seleye–Fabara D. Cancers of the uterine cervix in Port Harcourt, Rivers State, a 3 year clinic-pathological Nig. J. Med. 2004; (312):110 -3.
42. Anorlu RT. Orakwue CO, Oyeneyin L, Asdidu OO. Late presentation of patients with cervical cancer to a Tertiary Hospital in Lagos. What is responsible? Euro J Gynaecol oncology 2004; 25 (6): 729 32.
43. Udigwe GO. Knowledge, attitude and practice of cervical cancer screening. (Pap smear) among females nurses in Nnewi, South Eastern Nigeria. Nigerian J. Clin Practice 2006; 9(1):40, 43.
44. Moodley M. Mould S. Invasive cervical cancer and Human Immunodeficiency virus (HIV) infections in Kwazulu. Natal South Africa. J Obstract Gynaecol 2008. 25(7): 706.10. 

Dr Christopher Hassan Laima

Department of Obstetrics and Gynaecology, College of Medical Sciences, Gombe State University/Federal Teaching Hospital Gombe- Nigeria