Objectives To determine the epidemiological profile of cervical cancer in Tunisia and to specify the cost of treating the disease in order to develop an effective prevention strategy.
Methods It is a retrospective descriptive, multicenter study conducted in 6 obstetrical gynecology departments over a four-year period from January 1, 2016 to December 31,2019.
Results The number of all-stage cervical cancer in the different centers was 655 cases over a four-year period; which is equivalent to 166 cases/year. The average age of our patients was 53.5 years. More than half of our population did not have health insurance, and 38% were illiterate. The average age of sexual activity was 22.2 years. Cervical smear screening was performed in only 35 patients (17.9% of cases). The average consultation time in the study population was 5.6 months. The most frequent reason for consultation was metrorrhagia in 63%. A clear predominance of squamous cell carcinoma (82%) was noted. Tumors were classified according to the FIGO 2009 classification: 23.5% were diagnosed at an early stage (<IB1) and 76.3% at advanced stages (IB2 up to IV). Several therapeutic sequences were applied in our study series, the most frequent was surgery associated with radiotherapy and chemotherapy (60.1%). The direct annual cost of treatment was estimated at 1268502 DT (~ 465000 $). Radiotherapy represented the largest item of expenditure (37.4% of the cost of treatment).
Conclusions The control infectious origin’s pathology necessarily involves the implementation of national screening program, but also public awareness campaigns and mass vaccination against HPV of young virgin girls.
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