Cervical cancer prevention: safety, acceptability, and feasibility of a single-visit approach in Accra, Ghana

Am J Obstet Gynecol. 2007 Apr;196(4):407.e1-8; discussion 407.e8-9. doi: 10.1016/j.ajog.2006.12.031.

Abstract

Objective: The purpose of this study was to assess the safety and acceptability of a single-visit approach to cervical cancer prevention combining visual inspection of the cervix with acetic acid wash (VIA) and cryotherapy.

Study design: The study was observational. Nine clinicians were trained in VIA and cryotherapy. Over 18 months 3665 women were VIA-tested. If positive and eligible, cryotherapy was offered immediately. Treated women were followed-up at 3 months and 1 year.

Results: The test-positive rate was 13.2%. Of those eligible, 70.2% and 21% received immediate or delayed treatment, respectively. No major complications were recorded, and 5.6% presented for a perceived problem post-cryotherapy. Among those treated over 90% expressed satisfaction with their experience, and 96% had an indentifiable squamo-columnar junction. Only 2.6% (6/232) were test positive, 1-year posttreatment.

Conclusion: A single-visit approach using VIA and cryotherapy proved to be safe, acceptable, and feasible in an urban African setting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetic Acid / therapeutic use
  • Adult
  • Cervical Intraepithelial Neoplasia / pathology
  • Cervical Intraepithelial Neoplasia / prevention & control*
  • Cervical Intraepithelial Neoplasia / therapy
  • Cohort Studies
  • Confidence Intervals
  • Cryotherapy / methods
  • Cultural Characteristics
  • Developing Countries
  • Feasibility Studies
  • Female
  • Ghana
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Mass Screening / methods*
  • Middle Aged
  • Office Visits
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Compliance
  • Primary Prevention / organization & administration
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / prevention & control*
  • Uterine Cervical Neoplasms / therapy
  • Vaginal Smears

Substances

  • Acetic Acid