title: Feasibility, acceptability, and effectiveness of visual inspection of the cervix with acetic acid and cryotherapy for dysplasia in Nigeria.
abstract: OBJECTIVE
  To demonstrate the feasibility, acceptability, and effectiveness of visual inspection of the cervix with acetic acid (VIA) and treatment of dysplasia with cryotherapy in Nigeria.
  
  
  METHODS
  A prospective study was conducted at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria, between August 1, 2006, and July 31, 2009. Women aged 20-65 years who had had their sexual debut at least 3 years previously were screened for cervical dysplasia using VIA. Women with positive test results were offered cryotherapy immediately after screening.
  
  
  RESULTS
  Overall, 5529 women (mean age 40.24 ± 10.33 years) underwent screening with VIA. Dysplasia was detected among 317 (5.7%) women. Lesions suspicious for cancer were recorded among 52 (1.0%) women; histological diagnosis of invasive cervical cancer was confirmed in 38 (0.7%) women. VIA was as expected or better for 5330 (96.4%) women screened. Cryotherapy was as expected or better for 219 (99.5%) women who received treatment. Among 127 women who underwent cryotherapy and had repeat screening, 121 (95.3%) had negative test results after 1 year.
  
  
  CONCLUSIONS
  Cervical cancer screening using VIA and cryotherapy was feasible and effective despite scarce resources in the Nigerian health system. Furthermore, this approach was socially and culturally acceptable.
authors.affiliation: Department of Obstetrics and Gynaecology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Electronic address: peteradefuye2000@gmail.com.
authors.forename: Peter O
authors.initials: PO
authors.lastname: Adefuye
authors.affiliation: Center for Research in Reproductive Health, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
authors.forename: Olukayode A
authors.initials: OA
authors.lastname: Dada
authors.affiliation: Department of Medicine, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
authors.forename: Bolanle O
authors.initials: BO
authors.lastname: Adefuye
authors.affiliation: Department of Obstetrics and Gynaecology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
authors.forename: Tessie O
authors.initials: TO
authors.lastname: Shorunmu
authors.affiliation: Department of Obstetrics and Gynaecology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
authors.forename: Babatunde O
authors.initials: BO
authors.lastname: Akinyemi
authors.affiliation: Center for Research in Reproductive Health, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
authors.forename: Bolanle O
authors.initials: BO
authors.lastname: Idowu-Ajiboye
mesh_terms: D019342:Acetic Acid; D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery; D003452:Cryosurgery; D055088:Early Detection of Cancer; D005240:Feasibility Studies; D005260:Female; D058869:Gynecological Examination / Q000379:methods*; D006801:Humans; D007202:Indicators and Reagents; D008875:Middle Aged; D009549:Nigeria; D011446:Prospective Studies; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000601:surgery*; D055815:Young Adult
chemical_list: D007202:Indicators and Reagents; D019342:Acetic Acid
keywords: Acceptability; Cervical cancer; Cryotherapy; Dysplasia; Effectiveness; Feasibility; Nigeria; Visual inspection with acetic acid