Schistosomiasis and cervical cancer in Ghana

OBJECTIVE: To discover a possible association between schistosomiasis and cervical dysplasia and/or cervical cancer in Ghana, West Africa. METHOD: Two groups of 24 subjects each were identified, one group from a schistosomiasis-endemic area and a control group from a non-endemic area. Random cervical biopsies, cervical cytology and human papilloma virus (HP V) DNA testing were performed on all subjects. Demographic data were analyzed using Student's t-test. Histologic and DNA findings were analyzed using Fisher's exact test. RESULTS: From the endemic area, 46% of subjects had histologic evidence of schistosomiasis infection of the cervix. No evidence of dysplasia or cancer on cervical cytology was noted in this group. Mild dysplasia was noted in random cervix biopsies in one patient, and 8 patients had evidence of HPV infection of the cervix. No patient from the non-endemic area had cytologic or histologic evidence of cervical dysplasia or cancer. Eleven subjects in this group had evidence of HPV infection. CONCLUSION: This study does not reveal an association between cervical schistosomiasis and cervical dysplasia or cervical cancer on cytology or histology. Both study groups demonstrated a high degree of infection with HPV, however. It may be the HPV and not the schistosomiasis which is responsible for the development of uterine cervix cancer.