Prevention of Cervix Cancer in a Low Resources Country: Operational and Clinical Aspects of a Screening’s Network in a Suburb of Abidjan (C?te d’Ivoire)

摘要

Background: Cancer of the cervix is the most common cancer and the leading cause of death by cancer in women in developing countries. According to WHO, there were in 2002 in the world more than 500,000 new cases of cervical cancer, with more than 90% in developing countries. Secondary prevention of cervical cancer is done through screening of precancerous lesions and early diagnosis of cancer followed by treatment. Objectives: Our experience was reported in the management of a network of screening in the prevention of cancer of the uterine cervix. Method: After a program of training and upgrade to a pool of specialist doctor of obstetrics and gynaecology and midwifery centers health on visual screening methods, a reference site that is also a trainer site was defined and equipped with video-colposcopy and cryotherapy device. In April 2014, four peripheral sites have been installed with an equipment of lamp, magnifying glasses, acid acetic 5% and Lugol’s iodine. The screening network has been implemented and works on the model of reference-cross-reference. Results: The assessment of a year’s activity of the peripheral centers reported 993 patients, 653 consultations at the reference site, 106 precancerous lesions (6%), and 86 cases of references. The age of attendance peak lies in the age group of 35 - 55 years. Conclusion: The improvement of women’s participation requires organized screening, mass communication strategies, and systematic proposal of screening in consultation.