Setting up a community-based cervical screening service in a low-income country: a pilot study from north-western Tanzania

Nestory Masalu, Patrizia Serra, Dino Amadori, Jackson Kahima, Charles Majinge, Joyce Rwehabura, Oriana Nanni, Sara Bravaccini, Maurizio Puccetti, Rosario Tumino and Lauro Bucchi ()
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Nestory Masalu: Bugando Medical Centre (BMC)
Patrizia Serra: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS
Dino Amadori: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS
Jackson Kahima: Bugando Medical Centre (BMC)
Charles Majinge: Dodoma Christian Medical Centre (DCMC)
Joyce Rwehabura: Bugando Medical Centre (BMC)
Oriana Nanni: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS
Sara Bravaccini: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS
Maurizio Puccetti: S. Maria delle Croci Hospital
Rosario Tumino: Civic MP Arezzo Hospital, ASP Ragusa
Lauro Bucchi: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS

International Journal of Public Health, 2017, vol. 62, issue 7, No 7, 755-762

Abstract: Abstract Objectives To report the results of a pilot study for a service for cervical cancer screening and diagnosis in north-western Tanzania. Methods The pilot study was launched in 2012 after a community-level information campaign. Women aged 15–64 years were encouraged to attend the district health centres. Attendees were offered a conventional Pap smear and a visual inspection of the cervix with acetic acid (VIA). Results The first 2500 women were evaluated. A total of 164 women (detection rate 70.0/1000) were diagnosed with high-grade cervical intraepithelial neoplasia and invasive cervical cancer. The performance of VIA was comparable to that of Pap smear. The district of residence, a history of untreated sexually transmitted disease, an HIV-negative status (inverse association), and parity were independently associated with the detected prevalence of disease. The probability of invasive versus preinvasive disease was lower in HIV-positive women and in women practicing breast self-examination. Conclusions The diagnostic procedure had an acceptable level of quality. Factors associated with the detected prevalence of disease will allow for a more targeted promotion of the service. Cervical screening should be coordinated with sexually transmitted disease and HIV infection control activities.

Keywords: Sub-Saharan Africa; Cervical cancer; Prevalence; Screening (search for similar items in EconPapers)
Date: 2017
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DOI: 10.1007/s00038-017-0971-8

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