Cervical cancer screening in Primay Health Care

OBJECTIVES

To improve the reproductive health of Nicaraguan women through the implementation of an adequate, integrated pilot programme for cervical cancer screening at 3 levels (population, health care centre, district hospital).

METHODS

Population-based KAP study at start and end of project
Set up of screening- and treatment programme
Monitoring of attendance rate and follow-up rate
Comparison between cytology and visual inspection as screening tests

ACTIVITIES

Training of community health workers
Invitation of target population
Screening, colposcopy and treatment of precancerous lesions
Follow-up of women treated
Dissemination of results

RESULTS

At the end of the intervention, 63% of women of the target population had attended the screening programme, compared to 42.5% prior to the intervention
Of patients with abnormal screening tests, 80% attended the colposcopy clinic
Of women with high-grade lesions, 91% were treated and more than 90% attended the follow-up visits
Results were dissimated during the national workshops
Results of the KAP study and the peformance of the screening tests were published in international journals: Trop Med Int Health, 2002 Nov;7(11):935-41 and Trop Med Int Health, 2003 Aug;8(8):704-9.