Knowledge and Behavior of Women on Cervical Cancer in the Northern Region of Cameroon

• Armel HerveNwabo Kamdje

  Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Ngaoundere, Cameroun

• Georges Kalgong

  Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Ngaoundere, Cameroun

• Paul Takam Kamga

  University of Verona, Verona 37129, Italy

• Richard Simo Tagne

  Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Ngaoundere, Cameroun

• Jeremie Mbo Amvene

  Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Ngaoundere, Cameroun

• Charlette Nangue

  Anato-Cytopathology Laboratory, University Hospital Center of Yaoundé, Yaounde, Cameroun

 Background: Cervical cancer is a major cause of women death worldwide. The reduction of the mortality and morbidity of this pathology depends on the early detection based on powerful suitable screening methods, that will lead to optimal treatment strategies. However in some rural region of developing countries, it is very difficult to get access to standard screening methods, alternative screening methods, cheaper and easy to handle are then useful.

Objective: The aim of this work was to test the sensitivity and specificity of VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol iodine) as a diagnostic test of cervical cancer compared to the Pap Smear, evaluating the feasibility in health formation in the North Cameroon region, of implementing epidemiological surveillance of cervical cancer based on early diagnosis using the VIA-VILI association

Method: 309 women age 20 to 62 years were recruited in this study, 307 were included in the statistical analyzes. Each woman was screened for cervical cancer by a conventional Smear and visual inspection with acetic acid 5% and the lugol solution.

Results: We found in our study a prevalence of precancerous lesions of cervix at 12.70%. The risks factors of cervical cancer identified are age, matrimonial status, age of first sexual intercourse and parity. The association of VIA and VILI showed a sensitivity, specificity, positive and negative predictive value respectively about 93.58%; 97.01%; 82.01%, 99.04%.

Conclusion: Compared to PAP Smear, VIA or VILI could be used as an alternative screening methods for cervical cancer in developing countries, where it is difficult to access to more accurate test such as colposcopy and biopsy.

CCA_reportcard_low-res.pdf [Internet]. [cited 2017 Jul 9]. Available from: http://www.cervicalcanceraction.org/pubs/ CCA_reportcard_low-res.pdf

Regional Committee for Africa 60. Cancer of the cervix in the African Region: current situation and way forward [Internet] 2011 May [cited 2017 Jul 9]. Available from: http://www.who. int/iris/handle/10665/1684

Denny L. Cervical cancer: prevention and treatment. Discov Med 2012; 14 (75): 125-31.

WHO | Planning and implementing cervical cancer prevention and control programs [Internet]. WHO. [cited 2017 Jul 9]. Available from: http://www.who.int/reproductivehealth/ publications/cancers/a92126/en/

Arbyn M, Castellsague X, de Sanjose S, Bruni L, Saraiya M, Bray F, et al. Worldwide burden of cervical cancer in 2008. Ann Oncol 2011; 22 (12): 2675-86. https://doi.org/10.1093/annonc/mdr015

Saraiya M, Steben M, Watson M, Markowitz L. Evolution of cervical cancer screening and prevention in United States and Canada: Implications for public health practitioners and clinicians. Prev Med 2013; 57 (5): 426-33. https://doi.org/10.1016/j.ypmed.2013.01.020

Wright TC, Kuhn L. Alternative approaches to cervical cancer screening for developing countries. Best Pract Res Clin Obstet Gynaecol 2012; 26 (2): 197-208. https://doi.org/10.1016/j.bpobgyn.2011.11.004

Mandelblatt JS, Lawrence WF, Gaffikin L, Limpahayom KK, Lumbiganon P, Warakamin S, et al. Costs and benefits of different strategies to screen for cervical cancer in less-developed countries. J Natl Cancer Inst 2002; 94 (19): 1469-83. https://doi.org/10.1093/jnci/94.19.1469

Sankaranarayanan R, Wesley R, Thara S, Dhakad N, Chandralekha B, Sebastian P, et al. Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol’s iodine (VILI) in cervical cancer screening in Kerala, India. Int J Cancer 2003; 106 (3): 404-8. https://doi.org/10.1002/ijc.11245

Keshavarzi F, Nankali A, Fakheri T, Rezaei M, Khoshay A, Eslamizadeh N, et al. Cervical visual inspection with acetic acid as an alternative screening test for cervical cancer detection. Int J Collab Res Intern Med Public Health [Internet] 2015 Jun 1 [cited 2017 Jul 9]; 5 (1). Available from: http://internalmedicine.imedpub.com/abstract/cervical-visual-inspection-with-acetic-acid-as-an-alternativernscreening-test-for-cervical-cancer-detection-6245.html

WHO | Comprehensive cervical cancer control [Internet]. WHO. [cited 2017 Jul 9]. Available from: http://www.who.int/ reproductivehealth/publications/cancers/cervical-cancer-guide/en/

Akinola OI, Fabamwo AO, Oshodi YA, Banjo AA, Odusanya O, Gbadegesin A, et al. Efficacy of visual inspection of the cervix using acetic acid in cervical cancer screening: a comparison with cervical cytology. J Obstet Gynaecol J Inst Obstet Gynaecol 2007; 27 (7): 703-5. https://doi.org/10.1080/01443610701614421

Sarian LO, Derchain SF, Naud P, Roteli-Martins C, Longatto-Filho A, Tatti S, et al. Evaluation of visual inspection with acetic acid (VIA), Lugol’s iodine (VILI), cervical cytology and HPV testing as cervical screening tools in Latin America. This report refers to partial results from the LAMS (Latin AMerican Screening) study. J Med Screen 2005; 12 (3): 142-9. https://doi.org/10.1258/0969141054855328

Nkegoum B, Belley Priso E, Mbakop A, Gwent Bell E. [Precancerous lesions of the uterine cervix in cameroonian women. Cytological and epidemiological aspects of 946 cases]. Gynecol Obstet Fertil 2001; 29 (1): 15-20. https://doi.org/10.1016/S1297-9589(00)00024-2

Mpiga E, Ivanga M, Koumakpayi H, Engohan-Aloghe C, Ankély JC, Belembaogo E, et al. Intérêt de l’inspection visuelle à l’acide acétique et au soluté de Lugol avec colposcope dans le dépistage des lésions du col utérin au Gabon. Pan Afr Med J [Internet] 2015 [cited 2017 Jul 9]; 22. Available from: http://www.panafrican-med-journal.com/ content/article/22/165/full/

WHO | New WHO guide to prevent and control cervical cancer [Internet]. WHO. [cited 2017 Jul 9]. Available from: http://www.who.int/mediacentre/news/releases/2014/preventing-cervical-cancer/en/

Visual inspection with acetic acid for cervical-cancer screening: test qualities in a primary-care setting. University of Zimbabwe/JHPIEGO Cervical Cancer Project. Lancet Lond Engl 1999; 353 (9156): 869-73. https://doi.org/10.1016/S0140-6736(98)07033-0

Karimi-zarchi M, Zanbagh L, Shafii A, Taghipour-Zahir S, Teimoori S, Yazdian-Anari P. Comparison of Pap Smear and Colposcopy in Screening for Cervical Cancer in Patients with Secondary Immunodeficiency. Electron Physician 2015; 7 (7): 1542-8. https://doi.org/10.19082/1542

Peirson L, Fitzpatrick-Lewis D, Ciliska D, Warren R. Screening for cervical cancer: a systematic review and meta-analysis. Syst Rev 2013; 2: 35. https://doi.org/10.1186/2046-4053-2-35

Ghosh P, Gandhi G, Kochhar PK, Zutshi V, Batra S. Visual inspection of cervix with Lugol’s iodine for early detection of premalignant & malignant lesions of cervix. Indian J Med Res 2012; 136 (2): 265-71.

Moyer VA, U.S. Preventive Services Task Force. Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2012; 156 (12): 880-91, W312.

Bhattacharyya AK, Nath JD, Deka H. Comparative study between pap Smear and visual inspection with acetic acid (via) in screening of CIN and early cervical cancer. J -Life Health 2015; 6 (2): 53-8. https://doi.org/10.4103/0976-7800.158942

Consul S, Agrawal A, Sharma H, Bansal A, Gutch M, Jain N. Comparative study of effectiveness of Pap Smear versus visual inspection with acetic acid and visual inspection with Lugol’s iodine for mass screening of premalignant and malignant lesion of cervix. Indian J Med Paediatr Oncol Off J Indian Soc Med Paediatr Oncol 2012; 33 (3): 161-5. https://doi.org/10.4103/0971-5851.103143

Huchko MJ, Sneden J, Zakaras JM, Smith-McCune K, Sawaya G, Maloba M, et al. A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to Visual Inspection with Lugol’s Iodine for cervical cancer screening in HIV-infected women. PloS One 2015; 10 (4): e0118568. https://doi.org/10.1371/journal.pone.0118568

• PDF