- Volume 15 Issue 24
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Cervical Screening Using Visual Inspection with Acetic Acid (VIA) and Treatment with Cryotherapy in Fiji
- Fong, James (Colonial War Memorial) ;
- Gyaneshwar, Rajaneshwar (Lautoka Hospital) ;
- Lin, Sophia (School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales) ;
- Morrell, Stephen (School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales) ;
- Taylor, Richard (School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales) ;
- Brassil, Ann (Family Planning NSW) ;
- Stuart, Anne (Family Planning NSW) ;
- McGowan, Catherine (Family Planning NSW)
- Published : 2015.01.22
The purpose of this study was to demonstrate the feasibility of VIA screening with cryotherapy and to record normative values for indicators anticipated in similar low resource settings. Women aged 30-49 years were targeted, resulting in 1961 women screened and treated at two primary health care (PHC) centres near Suva, Fiji. Recruitment was through provision of information, education and communication (IEC). Referrals to a gynaecology outpatient department (OPD) at a referral hospital occurred throughout the screening pathway. Participation was 32% (95%CI 31-33%), higher in iTaukei (Melanesians) women (34%, 95%CI 33-36) compared to Fijians of Indian descent (26%, 95%CI 24-28). Regression analysis, adjusted for confounders, indicated significantly lower participation in those of Indian descent, and age groups 35-39 and 45-49 years. Of those examined by VIA, 190 were positive with aceto-white lesions (9.9%), within the expected range of 8-15%, with minor geographic and ethnic variation. Positive VIA results were more common in the peri-urban area, and in those aged 35-39 years. Of women aged 30-49 years, 59 received cryotherapy (none of whom had significant complications), 91 were referred to OPD, two cervical carcinomas were identified and eight cervical intra-epithelial neoplasms (CIN) II-III were diagnosed. These results provide normative findings from a community-based VIA screening program for other similar low resource settings.
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