Comparative Analysis of Clinical and Radiologic Staging of Cervical Cancer: A Cross-Sectional Study in Ethiopia

Abstract

Background: Cervical cancer remains a significant challenge in developing countries, with many patients diagnosed at advanced stages. The clinical staging of cervical cancer is guided by the International Federation of Obstetrics and Gynecology (FIGO) guidelines, while computed tomography (CT) and magnetic resonance imaging (MRI) offer valuable supplemental information. This study aimed to evaluate the initial clinical and imaging stages of cervical cancer and to assess the agreement between these staging methods.

Methods: A cross-sectional study was conducted involving 115 newly diagnosed cervical cancer patients at Tikur-Anbessa Specialized Hospital from September 1, 2022, to February 30, 2023. Clinical staging was performed for all patients, with CT staging for 107 and MRI staging for 34. Data were extracted from the hospital's central databases and analyzed using SPSS version 27. Descriptive and reliability analyses were conducted, with statistical significance set at a p-value of <0.05 and a 95% confidence interval.

Results: At diagnosis, 61 patients (53%) presented with advanced clinical stages (III-IV). CT imaging indicated advanced stages in 85 patients (73.9%), while MRI was performed on 34 patients. Agreement between clinical and CT-based staging was poor (weighted Cohen's kappa = 0.171, p = 0.016), while agreement between clinical and MRI-based staging was moderate (weighted Cohen's kappa = 0.418, p = 0.007).

Conclusion: Newly diagnosed cervical cancer patients exhibit a high prevalence of advanced-stage disease. There is poor agreement between clinical and CT-based cervical cancer staging, contrasted with moderate agreement between clinical and MRI-based staging.

Keywords: Advanced cervical cancer; FIGO; Tikur Anbessa Specialized Hospital (TASH); cervical cancer; computed tomography; magnetic resonance imaging.