An Insight into Cervical Cancer Screening and Treatment Capacity in Sub Saharan Africa

Jenell S. Coleman, Michelle S. Cespedes, Susan Cu-Uvin, Rose J. Kosgei, May Maloba, Jean Anderson, Timothy Wilkin, Antoine Jaquet, Julia Bohlius, Kathryn Anastos, Kara Wools-Kaloustian

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective Approximately 85% of cervical cancer cases and deaths occur in resource-constrained countries where best practices for prevention, particularly for women with HIV infection, still need to be developed. The aim of this study was to assess cervical cancer prevention capacity in select HIV clinics located in resource-constrained countries. Materials and Methods A cross-sectional survey of sub-Saharan African sites of 4 National Institutes of Health-funded HIV/AIDS networks was conducted. Sites were surveyed on the availability of cervical cancer screening and treatment among women with HIV infection and without HIV infection. Descriptive statistics and χ2 or Fisher exact test were used as appropriate. Results Fifty-one (65%) of 78 sites responded. Access to cervical cancer screening was reported by 49 sites (96%). Of these sites, 39 (80%) performed screening on-site. Central African sites were less likely to have screening on-site (p =.02) versus other areas. Visual inspection with acetic acid and Pap testing were the most commonly available on-site screening methods at 31 (79%) and 26 (67%) sites, respectively. High-risk HPV testing was available at 29% of sites with visual inspection with acetic acid and 50% of sites with Pap testing. Cryotherapy and radical hysterectomy were the most commonly available on-site treatment methods for premalignant and malignant lesions at 29 (74%) and 18 (46%) sites, respectively. Conclusions Despite limited resources, most sites surveyed had the capacity to perform cervical cancer screening and treatment. The existing infrastructure of HIV clinical and research sites may provide the ideal framework for scale-up of cervical cancer prevention in resource-constrained countries with a high burden of cervical dysplasia.

Original languageEnglish (US)
Pages (from-to)31-37
Number of pages7
JournalJournal of Lower Genital Tract Disease
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2016

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Africa South of the Sahara
Early Detection of Cancer
Uterine Cervical Neoplasms
HIV Infections
HIV
Acetic Acid
Therapeutics
Uterine Cervical Dysplasia
Cryotherapy
National Institutes of Health (U.S.)
Hysterectomy
Practice Guidelines
Acquired Immunodeficiency Syndrome
Cross-Sectional Studies
Research

Keywords

  • cervical cancer
  • HIV
  • HPV
  • Pap
  • VIA

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

An Insight into Cervical Cancer Screening and Treatment Capacity in Sub Saharan Africa. / Coleman, Jenell S.; Cespedes, Michelle S.; Cu-Uvin, Susan; Kosgei, Rose J.; Maloba, May; Anderson, Jean; Wilkin, Timothy; Jaquet, Antoine; Bohlius, Julia; Anastos, Kathryn; Wools-Kaloustian, Kara.

In: Journal of Lower Genital Tract Disease, Vol. 20, No. 1, 01.01.2016, p. 31-37.

Research output: Contribution to journalArticle

Coleman, JS, Cespedes, MS, Cu-Uvin, S, Kosgei, RJ, Maloba, M, Anderson, J, Wilkin, T, Jaquet, A, Bohlius, J, Anastos, K & Wools-Kaloustian, K 2016, 'An Insight into Cervical Cancer Screening and Treatment Capacity in Sub Saharan Africa', Journal of Lower Genital Tract Disease, vol. 20, no. 1, pp. 31-37. https://doi.org/10.1097/LGT.0000000000000165
Coleman, Jenell S. ; Cespedes, Michelle S. ; Cu-Uvin, Susan ; Kosgei, Rose J. ; Maloba, May ; Anderson, Jean ; Wilkin, Timothy ; Jaquet, Antoine ; Bohlius, Julia ; Anastos, Kathryn ; Wools-Kaloustian, Kara. / An Insight into Cervical Cancer Screening and Treatment Capacity in Sub Saharan Africa. In: Journal of Lower Genital Tract Disease. 2016 ; Vol. 20, No. 1. pp. 31-37.
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abstract = "Objective Approximately 85{\%} of cervical cancer cases and deaths occur in resource-constrained countries where best practices for prevention, particularly for women with HIV infection, still need to be developed. The aim of this study was to assess cervical cancer prevention capacity in select HIV clinics located in resource-constrained countries. Materials and Methods A cross-sectional survey of sub-Saharan African sites of 4 National Institutes of Health-funded HIV/AIDS networks was conducted. Sites were surveyed on the availability of cervical cancer screening and treatment among women with HIV infection and without HIV infection. Descriptive statistics and χ2 or Fisher exact test were used as appropriate. Results Fifty-one (65{\%}) of 78 sites responded. Access to cervical cancer screening was reported by 49 sites (96{\%}). Of these sites, 39 (80{\%}) performed screening on-site. Central African sites were less likely to have screening on-site (p =.02) versus other areas. Visual inspection with acetic acid and Pap testing were the most commonly available on-site screening methods at 31 (79{\%}) and 26 (67{\%}) sites, respectively. High-risk HPV testing was available at 29{\%} of sites with visual inspection with acetic acid and 50{\%} of sites with Pap testing. Cryotherapy and radical hysterectomy were the most commonly available on-site treatment methods for premalignant and malignant lesions at 29 (74{\%}) and 18 (46{\%}) sites, respectively. Conclusions Despite limited resources, most sites surveyed had the capacity to perform cervical cancer screening and treatment. The existing infrastructure of HIV clinical and research sites may provide the ideal framework for scale-up of cervical cancer prevention in resource-constrained countries with a high burden of cervical dysplasia.",
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