title: Cervical screening using visual inspection with acetic acid (VIA) and treatment with cryotherapy in Fiji.
abstract: 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.
authors.affiliation: Colonial War Memorial Hospital, Suva, Fiji E-mail : r.taylor@unsw.edu.au.
authors.forename: James
authors.initials: J
authors.lastname: Fong
authors.forename: Rajaneshwar
authors.initials: R
authors.lastname: Gyaneshwar
authors.forename: Sophia
authors.initials: S
authors.lastname: Lin
authors.forename: Stephen
authors.initials: S
authors.lastname: Morrell
authors.forename: Richard
authors.initials: R
authors.lastname: Taylor
authors.forename: Ann
authors.initials: A
authors.lastname: Brassil
authors.forename: Anne
authors.initials: A
authors.lastname: Stuart
authors.forename: Catherine
authors.initials: C
authors.lastname: McGowan
mesh_terms: D019342:Acetic Acid; D000328:Adult; D017679:Cryotherapy; D005240:Feasibility Studies; D005260:Female; D005367:Fiji; D005500:Follow-Up Studies; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000601:surgery*
chemical_list: D019342:Acetic Acid