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1295 Advancing cervical cancer screening in resource-limited settings: insights from the ELIKIA project in Kinshasa
  1. Monica Gutiérrez Martínez1,
  2. Luis Chiva De Agustin1,
  3. Silvia Carlos Chillerón2,
  4. Gabriel Reina González2,
  5. Pilar Sánchez García-Palacios2,
  6. Baby Celine Tendobi3,
  7. Beatriz Moreno Morueco1,
  8. Monica Sangrador Andreu1,
  9. Beatriz Fernández Zeka2,
  10. Victoria Sanz Reyes2,
  11. Maria Leyre Rodríguez Pocero2,
  12. Paula Alonso Alonso2,
  13. Inés Miranda Aróstegui2,
  14. Ainhoa Sanz Ruiz2,
  15. Alfonso Cabaleiro Díaz2,
  16. Alicia Novo Castillo2,
  17. Iranzu Etchepare2,
  18. Claudia Sainz Villate2,
  19. Pablo Guzmán Crespo2,
  20. Marta Larrañeta Pérez2,
  21. Irene Carlota Martínez Hierro2,
  22. María Hitos De Lorenzo2,
  23. Marta González Rodriguez2 and
  24. MaríaLuisa García Sanz1
  1. 1Clínica Universidad de Navarra (Sede Madrid), Madrid, Spain
  2. 2Clínica Universidad de Navarra (Sede Pamplona), Pamplona, Spain
  3. 3Hospital Monkole, Kinsasha, Congo (DRC)


Introduction/Background The ELIKIA Project, initiated in 2017 at Monkole Hospital, Kinshasa, aims to establish a sustainable and effective cervical cancer screening system for countries with limited access. Our objective is to provide a comprehensive early detection and treatment system for precancerous cervical lesions.

Methodology We present a descriptive study outlining the evolution and global results of our campaigns. Our hypothesis posits that visual inspection via acetic acid and lugol (VIA/VILI), conducted by trained clinicians (not necessarily doctors), is comparable to cytology.

We performed HPV testing, cytology and biopsy on all patients, which was subsequently analyzed in our center. Initially utilizing cryotherapy, in 2022, we validated thermoablation as an alternative treatment method and monitored patients undergoing this treatment during the campaign.

Results HPV infection affected 19% of women, with 21% showing multiple genotypes, including up to seven in a single patient. High-risk viruses, particularly types 16, 33, 35, and 52, caused 54% of infections. In high-grade lesions, type 16 was most prevalent (55.6%). Cytology results indicated 89% normal, 9% low-grade lesions, 2% high-grade lesions, and 1% cervical carcinoma.

Validation of diagnostic tests demonstrated significant predictive power:

  • Negative VIA/VILI test predicted a negative cytology in 94% and a negative HPV test in 87%.

  • The HPV test predicted a negative cytology in 95% and a negative biopsy in 93%.

  • Cytology predicted a negative biopsy result in 95%.

Thermoablation efficacy was notable, with an 80% negativization in cytology and 47% in the HPV test.

Conclusion VIA/VILI proves acceptable for cervical cancer screening, despite presenting numerous false positives (67% overtreatment). In the 2023 campaign, we evaluate a low-cost HPV test as an initial screening method, reserving VIA/VILI for positive cases. Thermoablation emerges as a valid therapeutic alternative, emphasizing both efficiency and simplicity in handling and transportation. These findings contribute valuable insights for advancing cervical cancer screening in resource-limited settings.

Disclosures .

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