title: Evaluation of visual inspection as the primary screening method in a four-year cervical (pre-) cancer screening program in rural China.
abstract: The aim of the study is to evaluate the feasibility of visual inspection with acetic acid/Lugol's iodine (VIA/VILI) as a primary screening method for cervical lesions in low-resource settings in China. Participants underwent VIA/VILI, and, if positive, received colposcopy and direct biopsy of visible lesions. Women who were negative for VIA/VILI or who were diagnosed with cervical intraepithelial neoplasia (CIN) 1 were re-screened the following year with the same procedure. In total, 10,269 women received VIA/VILI (of whom 8263, twice). Overall test positivity was 8.07% (1495/18532) for VIA/VILI, 33.44% (500/1495) for colposcopy, and the incidence of pathology-confirmed CIN1, CIN2/3 and cervical cancer was 0.85% (87/10,269), 0.53% (54/10,269) and 0.02% (2/10,269), respectively. Women aged 30-39 years at screening had higher rates of CIN2+ (include CIN2, CIN3 and cervical cancer). Our study indicates that VIA/VILI is a simple, feasible, and effective primary cervical cancer screening method in an impoverished, rural community that lacks access to standard medical care.
authors.affiliation: Department of Gynecological Oncology, Chongqing Cancer Institute/Hospital, Shapingba District, Chongqing 400030, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Li
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhou
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Shao-Min
authors.initials: SM
authors.lastname: Tong
authors.forename: Mei
authors.initials: M
authors.lastname: He
authors.forename: Hui
authors.initials: H
authors.lastname: Qiu
authors.forename: Jin-Song
authors.initials: JS
authors.lastname: Zhang
authors.forename: Qiao-Yu
authors.initials: QY
authors.lastname: Zhang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012424:Rural Population; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*
keywords: Cervical cancer; China; rural; screening; visual inspection