A histopathological review of gynaecological malignancies in Katsina state North-Western Nigeria

Background: Gynaecological cancers, which affect the female genital tract, constitute a significant public health problem, especially in developing countries. Some of these malignancies have known aetiology and premalignant stages making them preventable. Understanding the burden of gynaecological malignancies in our environment will provide baseline information and help form strategies for their control.

Aim: To describe the histological subtypes of gynaecological cancers, their frequency and age distribution trends in Katsina State over the 10-year study period.

Methods: This was a 10-year retrospective cross-sectional multicenter study of all histologically diagnosed gynaecological cancer cases seen from 1st January 2012 to 31st December 2021 at Federal Teaching Hospital Katsina, General Hospital Katsina and General Amadi Rimi Specialist Hospital Katsina. Data for this study were extracted from departmental record registers of the pathology laboratories of the corresponding hospitals whose laboratories provide pathology services to the State. Cancer distribution over the years was sorted based on the primary site of diagnosis, histological diagnosis and age. Data were analysed using Statistical Package for Social Science version 28 and results were presented in tables and charts.

Results: Two thousand three hundred and fifty-nine cancers were seen over the 10-year study period. Of these cases, 58.4% (n = 1,378) were females. Gynaecological malignancies accounted for 18.7% (441/2,359) of all cancers and 32.0% (441/1,378) of all female cancers. The highest frequency of gynaecological cancers was seen in women who were within the age groups of 40-49 and 50-59, and the lowest was seen in women who were ≥90 years old. The mean age was 48.9 ± 14.9 years. The most common site of gynaecological malignancies was the cervix uteri (n = 262, 59.4%) followed by the ovary (n = 106, 24.0%). Other sites in descending order were corpus uteri (n = 29, 6.6%), vulva (n = 9, 2.0%) and vagina (n = 2, 0.5%). The most common histo-morphologic subtypes were large-cell keratinizing squamous cell carcinoma in the cervix, large-cell non-keratinizing squamous cell carcinoma in the cervix and cystadenocarcinoma in the ovary. Choriocarcinoma was found in 33 cases (7.5%).

Conclusion: This study demonstrated the various histotypes of gynaecological malignancies and their trends in Katsina state. The leading cancer was found to be cervical cancer which is mainly preventable. It is hoped that data from this study will provide a basis for making and implementing policies and strategies to lessen the problems of gynaecological malignancies through regular screening programs, especially for cervical cancer and accepting human papilloma virus (HPV) vaccination take-up.