TITLE:
Screening for Cervical Cancer by Visual Inspection with Acetic Acid (VIA) in Nabil Choucair Health Center—Dakar (Senegal)
AUTHORS:
Babacar Biaye, Omar Gassama, Marie Édouard Faye Dieme, Youssoupha Touré, Mor Cissé, Mouhamadou Wade, Daba Diop, Bakhoum Assane, Mamour Gueye, Abdoul Aziz Diouf, Jean Charles Moreau
KEYWORDS:
Cervical Cancer Screening, VIA, Colposcopy, Dysplasia, Diathermic Loop Conization
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.3,
March
4,
2019
ABSTRACT: OBJECTIVES: 1) To draw up the epidemiological profile of patients who have benefited
from cervical cancer screening by visual inspection after application of acetic
acid (VIA) and then describe the results of the test, the colposcopy, histological
and therapeutic aspects in case of dysplasia. 2) To evaluate the performance of
IVA in cervical cancer screening and its feasibility in low-resource countries. MATERIALS AND METHODS: This was a prospective and descriptive study carried out from 06 June
2015 to 31 January 2016 (7 months) at the Maternity Center at Nabil Choucair
health center in Dakar. The patients had been screened for cervical cancer by
visual inspection, which consisted of applying 3% acetic acid after setting up
a vaginal speculum. The test was considered positive if there were intense
white areas in the cervix. Colposcopy was performed in case of a positive VIA
result. This colposcopy included an unprepared examination, an examination
after application of 3% acetic acid and an examination after application of Lugol solution. The colposcopic report
is made according to the terminology of the French Society of Colposcopy and
Cervico-Vaginal Pathology. Patients with major changes or unsatisfactory
colposcopy had undergone diathermic loop resection. Surgical specimens were
sent to pathologic anatomy and follow-up was performed according to the results
of the histology. The studied parameters concerned
the socio-demographic aspects, the results of the VIA test, the results of the
colposcopy after a positive test, the therapeutic aspects in case atypical
transformation zone grade 2 or of unsatisfactory colposcopy, the results of the
histology after the conization and the followed. The collection of data was done thanks to a file
and the statistical analysis thanks to the software Epi-info version 7. RESULTS:
899 patients were involved in the study. The epidemiologic profile of our
patient was a multipara in a period of genital activity, aged 42.2 years with a
mean gestational weight of 4.5, and a parity of 4. In our series, the patients
had their first sexual intercourse with 20.8 years old. In our study, 84
patients (10.2%) had positive results after visual inspection after acetic acid
applications. All patients with positive results after application of 3% acetic
acid had colposcopy. In our study, 27 patients had major changes and/or
unsatisfactory colposcopy and underwent diathermic loop resection for
diagnostic and therapeutic purposes. Anatomo-pathological examination of the
cone room revealed cervicitis in 22.2% of cases, flat condyloma in 7.4% of
cases, CIN2 in 22.2% of cases, and CIN3 in 18.5% of cases. All the conizations were in sano. The postoperative course was simple. CONCLUSION:
Cervical cancer is a real public health problem in developing countries. To do
to human resources, developing countries like Senegal must put in place simple,
inexpensive, effective strategies that must globally respond to “screen and
treat”.