Recent treatment outcomes of cervical intraepithelial neoplasia in south western Uganda: a six year retrospective study

Abstract

Background: There is limited real-world data on trends and distribution of treatment outcomes of cervical lesions in cervical cancer care settings in Uganda. We conducted this study to describe trends and the distribution of treatment outcomes for Cervical Intraepithelial Neoplasia (CIN) among women treated at Mbarara Regional Referral Hospital (MRRH), Southwestern Uganda. Methods: We conducted a retrospective census of women treated for CIN at the cervical cancer clinic and gynecology ward of MRRH from January 2020 to July 2025. Data on age, district of residence, HIV status, HPV test results, treatment modality, year of treatment, and treatment outcomes were extracted from clinic registers and patient records and analyzed using Stata 17. Results: We retrieved records of 184 women who had been treated for CIN, and their mean age was43.3 (±14.8). The majority (150/184, 81.5%) of CIN cases were documented as cured while the while 34/184 (18.5%) had persistent lesions. More than half of cases with persistent lesions also had unknown HIV status. Persistent CIN was mostly observed among women who were either positive with single HPV16 genotype (7/34, 20.6%) or HPV18/45 plus Other hrHPV genotypes (22/34, 64.7%). Conclusion: An increasing trend in persistent cervical intraepithelial neoplasia was observed over the study period, particularly among women with unknown HIV status and those with HPV16 infection or mixed HPV18/ 45 and other high-risk HPV infections. These findings highlight the need to strengthen integration of cervical precancer care into HIV services, reinforce the screen-and-treat approach, and improve post-treatment follow-up and monitoring.