EP046/#457 Outcomes of women diagnosed with cervical cancer as part of a screening program in Mozambique: a subset-analysis of the mulher study

Objectives

Mozambique has one of the highest burdens of cervical cancer globally. As cervical cancer screening programs are implemented, many women are identified with invasive cancer. Our objective was to describe the outcomes of women diagnosed with invasive cervical cancer as part of the MULHER cervical cancer screening study in Mozambique.

Methods

Women ages 30–49 were prospectively enrolled and offered cervical cancer screening with primary human papillomavirus (HPV) testing. HPV+ women underwent ablation or excision as appropriate. Those with findings suspicious for malignancy were referred to gynecologic oncologists trained through the IGCS Global Curriculum program.

Results

Between January 2020 and April 2022, 7,829 women underwent screening, with 32.3% found to be HPV+. 22 women were diagnosed with cervical cancer. Median age was 43 years and 14 (63.6%) were living with HIV. Five patients (22.7%) underwent radical hysterectomy; three of whom required adjuvant radiotherapy and/or chemotherapy. Three patients (13.6%) underwent neoadjuvant chemotherapy which was followed by radiotherapy in two patients, with one patient still awaiting radiotherapy. Three patients (13.6%) received chemotherapy only. No patients received primary chemoradiation due to limited capacity and long wait times for radiotherapy. Six patients (27.3%) received only palliative care or died prior to receiving any treatment and five patients are awaiting workup/treatment.

Conclusions

As cervical screening programs are implemented in low-resource settings, there will be an increase in the number of women diagnosed with invasive cervical cancer. Our results in Mozambique demonstrate the need to increase access to advanced surgery, radiation, and palliative care services.