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Organization and evaluation of a pilot cervical cancer screening program in Morocco
Author(s) -
Selmouni Farida,
Sauvaget Catherine,
Belakhel Latifa,
Lucas Eric,
Khouchoua Mohamed,
Sankaranarayanan Rengaswamy
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.06.044
Subject(s) - colposcopy , medicine , cervical intraepithelial neoplasia , cervical cancer , referral , cervical cancer screening , obstetrics , gynecology , loop electrosurgical excision procedure , cancer , family medicine
Objective To evaluate a pilot program for early detection of cervical cancer using visual inspection with acetic acid (VIA) and the loop electrosurgical excision procedure (LEEP) in one region of Morocco. Methods A descriptive analysis of the screening outcome measures of 43 participating primary care units and one reference center for LEEP was conducted in Meknès‐Tafilalet between January 1, 2011, and December 31, 2013. Data on the number of participants, VIA results, colposcopy, and treatment were used in analyses. Results Of the 308 197 women in the target age group (30–49 years), 18 586 (6.0%) were screened by VIA. Positive screening test results were recorded for 1628 (8.8%) women, of whom 1144 (70.3%) received diagnostic confirmation by colposcopy. Of the 87 (7.6%) women with cervical intraepithelial neoplasia, only 16 (18.4%) underwent LEEP; three cases of invasive cervical cancer were diagnosed. Conclusion Issues with implementation of the screening program were found, including low compliance and a low treatment rate of cervical intraepithelial neoplasia by LEEP. By contrast, high rates of colposcopy referral were observed. Screen‐and‐treat by ablative methods (e.g. thermocoagulation) should be considered to increase treatment rates at national scale‐up.