Kofi Nyarko

Background and Aims: Cervical cancer can be prevented by early detection through regular screening. The American Cancer Society advocates the initiation of cervical cancer screening from 25 years of age. Few studies in Ghana have used nationally representative data to examine the prevalence and predictors of cervical cancer screening (CCS). Therefore, this study examined the prevalence and predictors of CCS among women aged 25–49 years in Ghana. Methods: This study used cross‐sectional secondary data from the 2022 Ghana Demographic and Health Survey (GDHS), which involved 9510 women. Binary logistic regression was used to examine the predictors of CCS. All variables were considered statistically significant at a 95% confidence interval ( p ‐value < 0.05). Results: Overall, the prevalence of CCS was 6.90% (95% CI = 6.39%–7.41%). Women's age, educational level, marital status, parity, ecological zone, age at menarche, HIV testing, frequency of listening to the radio, and interaction between age and parity were predictors of CCS. On the one hand, women who had 6 or more children (95% CI = 0.04–0.54), those aged 45–49 years with 4–5 children (95% CI = 0.04–0.98), and those with menarche at ≥ 15 years (95% CI = 0.59–0.97), were less likely to screen for cervical cancer. On the other hand, women with tertiary education (95% CI = 1.07–10.84), those from the Northern ecological zone (95% CI = 1.34–3.23), and those who had ever tested for HIV (95% CI = 1.49–3.36), were more likely to screen for cervical cancer. Conclusion: The prevalence of CCS is low in Ghana, and there is an urgent need for policymakers to enhance health promotion campaigns on cervical cancer screening to increase the uptake of screening services.

Coronavirus disease 2019, is an infectious disease caused by the severe acute respiratory syndrome corona virus type-2 virus. Children affected are usually

Supplementary Table S3: Beta coefficients (β) and 95% confidence intervals (CI) for the associations of breast cancer risk factors and clinicopathological characteristics with tumor grade among breast cancer patients participating in the Ghana Breast Health Study

Supplementary Table S1: Optimized machine learning parameters for cell detection on digitized hematoxylin and eosin-stained breast cancer sections from participants in the Ghana Breast Health Study

Supplementary Figure S1: Correlation between standard Ta-SCD and percent Ta-SCD. Standard Ta-SCD was calculated by dividing the total number of cells in the stroma by the total stromal area (mm2). Standard Ta-SCD was converted to a percentage by multiplying the total number of nucleated cells by the average area (mm2) of a single nucleus to generate total nuclei area (mm2), dividing this by the total stromal (cellular + non-cellular) area (mm2), and multiplying by 100.

Supplementary Table S2: Beta coefficients (β) and 95% confidence intervals (CI) for the associations of breast cancer risk factors and clinicopathological characteristics with tumor-associated stromal cellular density among breast cancer patients participating in the Ghana Breast Health Study

Background:The stromal microenvironment (SME) is integral to breast cancer biology, impacting metastatic proclivity and treatment response. Emerging data indicate that host factors may impact the SME, but the relationship between prediagnostic host factors and SME phenotype remains poorly characterized, particularly among women of African ancestry.Methods:We conducted a case-only analysis involving 792 patients with breast cancer (17–84 years) from the Ghana Breast Health Study. High-accuracy machine-learning algorithms were applied to standard H&E-stained images to characterize SME phenotypes [including percent tumor-associated connective tissue stroma, Ta-CTS (%); tumor-associated stromal cellular density, Ta-SCD (%)]. Associations between prediagnostic host factors and SME phenotypes were assessed in multivariable linear regression models.Results:Decreasing Ta-CTS and increasing Ta-SCD were associated with aggressive, mostly high-grade tumors (P-value < 0.001). Several prediagnostic host factors were associated with Ta-SCD independently of tumor characteristics. Compared with nulliparous women, parous women had higher levels of Ta-SCD [mean (standard deviation, SD) = 31.3% (7.6%) vs. 28.9% (7.1%); P-value = 0.01]. Similarly, women with a positive family history of breast cancer had higher levels of Ta-SCD than those without family history [mean (SD) = 33.0% (7.5%)] vs. 30.9% (7.6%); P-value = 0.03]. Conversely, increasing body size was associated with decreasing Ta-SCD [mean (SD) = 31.6% (7.4%), 31.4% (7.3%), and 30.1% (8.0%) for slight, average, and large body sizes, respectively; P-value = 0.005].Conclusions:Epidemiological risk factors were associated with varying degrees of stromal cellularity in tumors, independently of clinicopathological characteristics.Impact:The findings raise the possibility that epidemiological risk factors may partly influence tumor biology via the stromal microenvironment.See related In the Spotlight, p. 459

Supplementary Table S4: Coefficients and 95% confidence intervals (CI) for the associations of breast cancer risk factors and clinicopathological characteristics with parity (vs nulliparous) among breast cancer patients participating in the Ghana Breast Health Study

Supplementary Table S5: Beta coefficients (β) and 95% confidence intervals (CI) for the associations between breast cancer risk factors and Tumor-associated Stromal Cellular Density (Ta-SCD) among patients <50 and ≥50 years of age participating in the Ghana Breast Health Study

Supplementary Table S6: Beta coefficients (β) and 95% confidence intervals (CI) for the associations between breast cancer risk factors and Tumor-associated Stromal Cellular Density among patients with ER+ and ER- breast cancer participating in the Ghana Breast Health Study