To achieve higher coverage and effectiveness in limited-resource settings, World Health Organization (WHO) guidelines for cervical cancer prevention recommend a screen-and-treat strategy with high-risk human papillomavirus (HPV) testing. We piloted a real-word project to examine the feasibility of this approach in rural Cameroon. Nurses from the Women's Health Program (WHP) of the Cameroon Baptist Convention Health Services (CBCHS) educated women in remote villages on cervical cancer prevention. At a follow-up visit, they explained to nonpregnant women aged 30-65 how to self-collect vaginal specimens for HPV testing with the careHPV assay. The cytobrush specimens were transported in coolers to a CBCHS laboratory for analysis. The nurses returned to villages to inform women of their results, examined HPV-positive women in the primary health centers (PHCs) using visual inspection with acetic acid and Lugol's iodine (VIA/VILI) enhanced by digital cervicography (DC) to guide treatment. Of the 1,270 eligible women screened (mean age: 44.7 years), 196 (15.4%) were HPV-positive, of whom 185 (94.4%) were examined, 16 (8.6%) were VIA/VILI-positive, 8 (4.3%) were VIA/VILI-inadequate, one (0.5%) was VIA/VILI-uncertain and 161 (87.0%) were treated with thermal ablation. One woman had LEEP, and another woman with invasive cancer was treated at a referral facility. The cytobrushes broke off in the vaginas of two women (removed in the village) and in the bladder of another (surgically removed). Community-based cervical cancer screening with self-collected specimens for HPV testing is feasible in rural Cameroon. Education on the proper sampling procedure and follow-up of women who are HPV-positive are essential.

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Highlights Of 151 endometrial biopsies, 36.7% had endometrial hyperplasia/cancer. The remaining 63.3% had benign/infectious pathology findings. Therefore, over 1 in 3 women with abnormal uterine bleeding had endometrial hyperplasia or cancer.

Introduction: Cervical cancer ranks as the fourth most frequently diagnosed cancer and the fourth leading cause of cancer-related deaths among women globally. In LMIC, most women with cervical cancer are diagnosed at an advanced stage, partly because they have limited access to a proper diagnosis. Treatment options are limited due to limited access to radiation therapy. Thus, survival outcomes are poor. There is no data on this issue in Cameroon, so we undertook to determine the survival outcomes for women who present with cervical cancer to the CBCHS.Method: Data was extracted from the cervical screening and diagnostic Women's Health Program (WHP) database. All cases of cervical cancer were followed through the CBCHS oncology service, so management and clinical outcomes were available. Outcomes were categorized as alive with disease, alive without disease or dead. Kaplan-Meier (KM) curves for survival were plotted stratified by age, HIV status and histologic subtype. The Cox regression model for survival analysis was used to determine the impact of some variables on the mean time of patient survival after diagnosis.Results: Between 2013 and 2018, 752 women were diagnosed with cervical cancer. The average age at cervical cancer diagnosis was 53.33 (+/-13.82), with a mean survival time of 2.34 years (+/-2.00). Within five years of diagnosis, the overall survival for women diagnosed with cervical cancer was 27.1%. 285 (37.5%) cases diagnosed did not go in for treatment. 387 (51.5%) went in for treatment, including 205 who did not complete their treatment. Age at diagnosis (HR 1.007 (95% Cl (1.000-1.013), p=0.035), a positive HIV status (HR 1.032 (95%Cl (0.930-1.145)) p = 0.558), and histologic subtype of adenocarcinoma (HR 1.026 (95% Cl (0.705-1.493), p=0.894) were associated with lower survival (although these associations were not statistically significant). Conclusion:A diagnosis of cervical cancer is a serious threat to the health of women especially in LMIC like Cameroon. Survival from the disease is extremely poor in this country, consistent with data from other LMICs. Most cases present late with symptoms, and the majority cannot afford treatment reflected by the very few who attend recommended forms of treatment or are unable to complete it. Education, and awareness around primary and secondary prevention and universal health care funding are necessary steps to strengthen cervical cancer control in Cameroon.