Evaluation of Visual and Cytology Screening in Preventing Cervical Intraepithelial Neoplasia and Cervical Cancer in Namibia

Abstract

An estimated 851 340 women in Namibia are at risk of human papilloma viral (HPV) infection that may cause cervical cancer. Visual screening with acetic acid (VIA) and cryotherapy have been proven highly effective. However, data associating with the impact of cervical cancer screening programmes lack. This study evaluated visual and cytology screening in preventing cervical intraepithelial lesions (CIN) and cervical cancer in Namibia. Findings showed that women with HPV, cervicitis, koilocytosis and atypia are at an increased risk of testing positive for VIA. Older women, particularly with HIV are more likely to be diagnosed with squamous cell carcinoma (SCC). VIA procedure seems to be viable in screening, although colposcopy in patient follow-up in the Namibian context should be revised and used with positive HR-HPV results. Screening modalities incorporating HPV testing for different ages and risk populations (e.g. HIV positive, autoimmune disease) is recommended. Screening uptake can further be improved by interventions that adopt a model which uses previous diagnostic outcomes, women’s health objectives, up-to-date knowledge and practice relevant to national context.