Screening for cervical neoplasia in Mamelodi--lessons from an unscreened population.
OBJECTIVE
To determine the prevalence of abnormal cervical cytological findings in an unscreened population; to assess patients' awareness of cervical cancer and the importance of early diagnosis; and to evaluate the accuracy of visual inspection of the cervix as a screening method for asymptomatic cervical cancer.
Descriptive.


METHODS
Mamelodi Hospital, a community day hospital east of Pretoria, serving a black urbanised population that had never been exposed to a routine cervical cytological screening programme.


METHODS
One thousand and ninety-five women of reproductive age, who presented with a non-gynaecological complaint, were offered cervical cytological testing and were asked to complete a questionnaire. Visual appreciation of the cervical condition was noted and compared with the cytology report.


RESULTS
The prevalence of abnormal cervical cytological findings (low- and high-grade squamous cervical intra-epithelial neoplasia (CIN), excluding human papillomavirus-induced cell changes only) was 54/1,000. Only 2% of the patients had a good knowledge of cervical cancer and cervical screening. Visual inspection of the cervix detected 4 out of 5 cervical cancers in this group, but failed to identify those patients with high-grade CIN.


CONCLUSIONS
This study shows a high prevalence of abnormal cervical cytological findings in a population ignorant about cervical cancer. Recommendations on how to improve this situation are made.
Heystek
M J
MJ
Department of Family Medicine, University of Pretoria.
de Jonge
E T
ET
Meyer
H P
HP
Lindeque
B G
BG
D000328:Adult; D001741:Black or African American; D044383:Black People; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology