title: Cervical cancer screening: Safety, acceptability, and feasibility of a single-visit approach in Bulawayo, Zimbabwe.
abstract: BACKGROUND
  Cervical cancer is the commonest cancer amongst African women, and yet preventative services are often inadequate.
  
  
  OBJECTIVE
  The purpose of the study was to assess the safety, acceptability and feasibility of visual inspection with acetic acid and cervicography (VIAC) followed by cryotherapy or a loop electrical excision procedure (LEEP) at a single visit for prevention of cancer of the cervix.
  
  
  METHODS
  The United Bulawayo Hospital, Zimbabwe.
  
  
  METHODS
  The study was descriptive, using retrospective data extracted from electronic medical records of women attending the VIAC clinic. Over 24 months 4641 women visited the clinic and were screened for cervical cancer using VIAC. Cryotherapy or LEEP was offered immediately to those that screened positive. Treated women were followed up at three months and one year.
  
  
  RESULTS
  The rate of positive results on VIAC testing was 10.8%. Of those who were eligible, 17.0% received immediate cryotherapy, 44.1% received immediate LEEP, 1.9% delayed treatment, and 37.0% were referred to a gynaecologist. No major complications were recorded after cryotherapy or LEEP. Amongst those treated 99.5% expressed satisfaction with their experience. Only 3.2% of those treated at the clinic had a positive result on VIAC one year later. The service was shown to be feasible to sustain over time with the necessary consumables. There were no service-related treatment postponements and the clinic staff and facility were able to meet the demand for the service.
  
  
  CONCLUSIONS
  A single-visit approach using VIAC, followed by cryotherapy or LEEP, proved to be safe, acceptable and feasible in an urban African setting in Bulawayo, Zimbabwe. Outcomes a year later suggested that treatment had been effective.
authors.forename: Muriel S
authors.initials: MS
authors.lastname: Fallala
authors.affiliation: Division of Family Medicine and Primary Care, Stellenbosch University. rm@sun.ac.za.
authors.forename: Robert
authors.initials: R
authors.lastname: Mash
mesh_terms: D019342:Acetic Acid; D000328:Adult; D000553:Ambulatory Care / Q000379:methods* / Q000523:psychology; D002584:Cervix Uteri / Q000473:pathology; D003430:Cross-Sectional Studies; D017679:Cryotherapy / Q000379:methods; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D055088:Early Detection of Cancer / Q000379:methods* / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods* / Q000523:psychology; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D015030:Zimbabwe
chemical_list: D019342:Acetic Acid