Feasibility, acceptability, and effectiveness of visual inspection of the cervix with acetic acid and cryotherapy for dysplasia in Nigeria

Objective: To demonstrate the feasibility, acceptability, and effectiveness of visual inspection of the cervix with acetic acid (VIA) and treatment of dysplasia with cryotherapy in Nigeria. Methods: A prospective study was conducted at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria, between August 1, 2006, and July 31, 2009. Women aged 20-65 years who had had their sexual debut at least 3 years previously were screened for cervical dysplasia using VIA. Women with positive test results were offered cryotherapy immediately after screening. Results: Overall, 5529 women (mean age 40.24 +/- 10.33 years) underwent screening with VIA. Dysplasia was detected among 317 (5.7%) women. Lesions suspicious for cancer were recorded among 52 (1.0%) women; histological diagnosis of invasive cervical cancer was confirmed in 38 (0.7%) women. VIA was as expected or better for 5330 (96.4%) women screened. Cryotherapy was as expected or better for 219 (99.5%) women who received treatment. Among 127 women who underwent cryotherapy and had repeat screening, 121 (95.3%) had negative test results after 1 year. Conclusion: Cervical cancer screening using VIA and cryotherapy was feasible and effective despite scarce resources in the Nigerian health system. Furthermore, this approach was socially and culturally acceptable. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.