Introduction/Background Cervical cancer has been considered the second most common female malignant tumor in developing countries. The mortality from cervical cancer is 18 times more in low-resource countries. Till now; no national screening or HPV vaccination programs in Egypt and most of low-resource countries. Although HPV-DNA test is the most accurate screening test; it is still expensive and not offered in our low-resource countries.
Methodology The early results of the initiative of Mansoura Gynecologic Oncology Unit in collaboration with Ministry of Health to screen and treat eligible women for pre-invasive cervical lesions in Lower Egypt. The project depends on training of gynecologists for screening, population screening during district visits, and treatment of the diagnosed cases. Diagnosis of CIN based on simple, cheap visual inspection with acetic acid (VIA) with referral of positive cases for colposcopic examination and guided cervical biopsy. The diagnosed cases were treated according to WHO guidelines.
Our detailed project of screening and HPV vaccination is being discussed in the Egyptian Parliament.
Results After one year of the project; 9 peripheral districts were visited and more than 5000 women were screened. The acceptability of women and collaboration of community leaders were excellent. Fifty-two cases (1/1000) were diagnosed with CIN and 6 invasive tumors . Twenty-eight of them were CINI, 20 cases with CIN II & 4 cases with CIN III. Conservative treatment was applied to 27 cases with CIN I. Cryotherapy was applied to 6 cases. Loop Electrosurgical Excision Procedure (LEEP) was performed in 14 cases. Trachelectomy was done to one case. Simple hysterectomy was performed to 9 cases.
Conclusion The early results of Mansoura initiative of cervical cancer elimination in Lower Egypt is promising. The strategy can be implemented in other low-resource countries under umbrella of ESGO. A national-based screening and HPV vaccination programs are highly recommended.
Disclosures No conflicts of interest
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