Pattern of Gynaecological Cancers in Ghana

Objective: To determine the relative frequencies of gynaecological cancers in Ghana, age and parity distribution, stage of disease at presentation and the influence of age and parity on stage at presentation.

Design: Retrospective observational study.

Setting: Korle Bu Teaching Hospital, Accra, Ghana.

Subjects: Cases of gynaecological cancers seen in a fifty two month period.

Results: Cervical cancer was the commonest, constituting about 57.8% of gynaecological cancers. Ovarian cancer, endometrial cancer, choriocarcinoma and vulval carcinoma followed in that order. The mean age and parity for cervical carcinoma (52.0[SD12.0] years, 5.8[SD2.7] respectively) were significantly higher than those for ovarian carcinoma (46.4[SD15.0] years, 3.5[SD3.0] respectively) but not significantly different from those for endometrial carcinoma (56.0[SD13.5] years, 5.4[SD3.0] respectively). Most patients with cervical or ovarian carcinoma presented with advanced disease while most with endometrial carcinoma presented with early stage disease. Age and parity did not have any influence on the stage at presentation with cervical or ovarian carcinoma. Concerning endometrial carcinoma, although age did not influence stage at presentation, women of high parity (> or = 5) presented with earlier stage disease than those of parity less than 5.

Conclusion: As a first step towards reducing the morbidity and mortality associated with gynaecological cancers in Ghana, appropriate steps must be taken to reduce the incidence of cervical carcinoma. In addition, detailed study of the epidemiology of cervical and endometrial cancers in Ghanaian women is needed to determine whether they share any other common antecedents in addition to age and parity.