Abstract 771: Cervical cancer: Our experience in Sudan
Authors: Mohamed Kamal Eldein H. , Ashmeig Dr Ammar Ashmeig Ahmed 
Published: July 2017

Abstract
Introduction: Cervical cancer is the second most prevalent cancer in Sudanese Women; breast cancer forms between 29 - 35% of female cancers while Ca Cervix forms 12 - 16%. There are limited screening activities in the country using VIA, and Pap smears in Obs. and Gyn. clinics. With the main emphasis on health education programs, teaching women the early symptoms of ca cervix and early detection. Due to lack of awareness the majority of women don’t know anything about screening, so there is limited demand.
Method: This is a retrospective study of 405 Cases of Ca Cervix treated during the period between 2000—2013 at the Radiation and Isotopes Center of Khartoum, RICK. Data was collected from patients records.
Results: Age distribution showed,&lt;40 years =8 = 2 %,41 -50 = 94 =23.2%,51—60 = 187 = 46.2%,61—70 = 102 = 25.2%,&gt;70 14= =3.5%. Age range =28—79,mean age =47 years.
Residence distribution was as follows, western Sudan = 48 %,central Sudan = 41.%,North = 7%,East = 4%.
Length of duration of symptoms, range between 1—10 months, mean of 5 months.
FIGO Stage distribution: Stage 1= 6%, Stage 2 A =13%.Stage 2 B =23%,Stage 3 A=18%,Stage 3B =34%,Stage 4 A,B =7%,.
Pathology: poorly dif. Squamous ca 38%, moderately dif. Squamous 26%,well dif 25%,Adenocarcinoma 9%,others 2%.
Treatment: external Radiotherapy,45-50 Gy in 20—25 fractions, by 2 or 4 fields, using Co 60 or lineacs 6,9 Mv, concurrent chemo radiotherapy was given to patients with stage 2B, 3A, 3B, and 4A. Using weekly Cisplatinum, this was given to 32% of
patients. 60 %% of the patients had Brach therapy, 34% with Low Dose Rate, LDR, Manual Brachy therapy, 35Gy to point A,and 66% had High Dose Rate Brachy, HDR, 9 Gy x 2 sessions, using a cobalt source.
Results: 175 patients (43.3%) survived for 5 years and more, mostly patients with stage one and two 158 = 39% survived for 3-4 years after treatment,39 patents = 9.6 %, mostly patients with stage four, died during follow up due to the disease and 33 patients = 8.2% disappeared after treatment. The poor outcome is attributed to the advanced stages at presentation, lack of screening and awareness about cervical cancer, poverty, illiteracy, the large size of the country and the poor distribution of the limited medical resources. The patients treated with LDR or HDR have equal outcome and morbidity.
Conclusion: Most of Ca Cervix Patients present with advanced disease, hence the poor prognosis, due to lack of awareness and screening, illiteracy and poverty, the majority are poorly differentiated squamous cancers. There is a need for increasing public awareness about ca cervix and its early symptoms, and provision of a pap smear and VIA services in the primary health care facilities.
Citation Format: Kamal Eldein H. Mohamed, Dr Ammar Ashmeig Ahmed Ashmeig. Cervical cancer: Our experience in Sudan [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 771. doi:10.1158/1538-7445.AM2017-771