title: Single-visit approach of cervical cancer screening: see and treat in Indonesia.
abstract: BACKGROUND
  We performed a cross-sectional study in Indonesia to evaluate the performance of a single-visit approach of cervical cancer screening, using visual inspection with acetic acid (VIA), histology and cryotherapy in low-resource settings.
  
  
  METHODS
  Women having limited access to health-care facilities were screened by trained doctors using VIA. If the test was positive, biopsies were taken and when eligible, women were directly treated with cryotherapy. Follow-up was performed with VIA and cytology after 6 months. When cervical cancer was suspected or diagnosed, women were referred. The positivity rate, positive predictive value (PPV) and approximate specificity of the VIA test were calculated. The detection rate for cervical lesions was given.
  
  
  RESULTS
  Screening results were completed in 22 040 women, of whom 92.7% had never been screened. Visual inspection with acetic acid was positive in 4.4%. The PPV of VIA to detect CIN I or greater and CIN II or greater was 58.7% and 29.7%, respectively. The approximate specificity was 98.1%, and the detection rate for CIN I or greater was 2.6%.
  
  
  CONCLUSIONS
  The single-visit approach cervical cancer screening performed well, showing See and Treat is a promising way to reduce cervical cancer in Indonesia.
authors: Department of Gynaecology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, Leiden 2300 RC, The Netherlands. j.n.i.vet@lumc.nl
authors: J N I
authors: JN
authors: Vet
authors: J L
authors: JL
authors: Kooijman
authors: F C
authors: FC
authors: Henderson
authors: F M
authors: FM
authors: Aziz
authors: G
authors: G
authors: Purwoto
authors: H
authors: H
authors: Susanto
authors: I G D
authors: IG
authors: Surya
authors: S
authors: S
authors: Budiningsih
authors: S
authors: S
authors: Cornain
authors: G J
authors: GJ
authors: Fleuren
authors: J B
authors: JB
authors: Trimbos
authors: A A W
authors: AA
authors: Peters
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D017679:Cryotherapy / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D007214:Indonesia; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D014626:Vaginal Smears / Q000379:methods