Perceptions of risk and barriers to cervical cancer screening at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya.

BACKGROUND: Affordable screening cervical cancer methods using visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI) are being developed. Scaling up of screening services requires an understanding of the user perceptions about screening. OBJECTIVES: Determine the perceptions of risk and barriers to previous cervical cancer screening by women attending MCH-FP clinic of MTRH, Eldoret, Kenya. METHODS: Cross-sectional questionnaire survey involving a consecutive sample of 219 consenting non-pregnant women about perceptions on cervical cancer risk, barriers to screening and previous screening. RESULTS: Of 219 women interviewed, 12.3% of participants had screened before. Women of over 30 years were more likely to have screened before (p=0.012). While 22.8% felt that they were at risk of the cervical cancer, 65% of all participants, nevertheless, wished to be screened. Perception of being at risk was significantly associated with a felt need for screening (p=0.002), an association that persisted only for women reporting multiple lifetime sex partners (p=0.005). Fear of abnormal results and lack of finances were the commonest barriers to screening reported by 22.4% and 11.4% of respondents, respectively. CONCLUSIONS: Previous screening was uncommon. Cheaper screening methods are needed. Messages about screening should clarify the meaning and consequences of possible results.

Integrating cervical cancer and genital tract infection screening into mother, child health and family planning clinics in Eldoret, Kenya.

BACKGROUND: Visual inspection, with acetic acid (VIA) and with Lugol's iodine (VILI), has been demonstrated to have test characteristics comparable to those of Pap smear but are more affordable and easier implement. It also presents an opportunity for management of female genital tract infection. OBJECTIVES: Pilot test integration of cervical cancer screening using visual inspection with genital tract infection identification into an existing MCH-FP in MTRH. METHODS: Cross sectional, descriptive study in which consecutive women were screened for genital tract inflammatory morbidity and cervical cancer through visual inspection. RESULTS: Two hundred and nineteen women with a mean age of 31-3 years, parity of 3.1 were screened. About 54% of study participants had multiple sex partners, 62% had sexual debut earlier than 20 years, while use of tobacco was reported by 4%. The test positivity rate was 13.9% and 16.9% for VIA and VILI respectively. Positive test finding was significantly related to contraceptive never-use after controlling for previous screening (p=0.006).Symptoms of genital tract infections were reported by 38% of the participants with features of cervicitis being reported by nearly 24%. CONCLUSION: Integration of cervical cancer screening and genital tract infection identification and treatment into the existing MCH-FP appears feasible.