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EV369/#172  Cervical cancer and STI screening in Liberia: comparison of currently used cervical cancer screening methods. cervical cancer and sexually transmitted infections screening in Liberia: comparison of currently used cervical cancer screening methods
  1. Deazee Saywon1,
  2. Ann Beddoe2,
  3. Peter Dottino3,
  4. Jack Murphy4,
  5. Wilhemina Jallah5 and
  6. Sopouassi King1
  1. 1John F. Kennedy Memorial Hospital, Department of Obstetrics and Gynecology, Monrovia, Liberia
  2. 2The Women Global Cancer Initiative, New York, USA
  3. 3Yale School of Medicine, Department of Obstatrics, Gynecology and Reproductive Science, New Haven, USA
  4. 4The Women Global Cancer Initiatve, New York, USA
  5. 5Hope for Women Medical Center, Monrovia, Liberia

Abstract

Introduction Cervical cancer is the most common cancer among women in Liberia. Without a national screening program, Pap smear and visual inspection with acetic acid (VIA) are the most utilized screening tools. A program that compared Pap and VIA with high-risk HPV (hr-HPV) and screening for sexually transmitted infections (STIs) is reported.

Methods Percent positivity rate was calculated for all tests performed. Diagnostic test accuracy (DTA): test performance and agreement of VIA and Pap with hr-HPV was calculated as percent positive agreement (PPA) and percent negative agreement (PNA) using conventional 2x2 tables. PPA and PNA were used as surrogates for sensitivity and specificity. .

Results Among 978 participants, 507 received VIA, 342 Pap and 352 hr-HPV. Percent positivity Rates: VIA 9.27% (47/507) Pap 7.89% (27/342) hr-HPV 17.62% (62/352) Test performance and agreement compared to HPV: VIA PPA 14.06% PNA 89.7% Pap PPA 24.1% PNA 89.1% STIs positivity rates: HIV 3.4% (25/722) Gonorrhea 0.59% (2/339) Chlamydia 0.59% (2/339) Syphilis 1.8% (25/722) HPV-HIV co-infection: 13/15 (86.7%) who tested positive for syphilis were HIV+.

Conclusion/Implications hr-HPV positivity rate of 18% is the first objective assessment of HPV positivity among screened women in Liberia. Although VIA is the most cost-effective, and utilized screening method in Liberia, its percent positive agreement with hr-HPV is the lowest of the two currently used screening tests suggesting the need for increased focus on training as its use increases.

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