Application of opportunistic screening for cervical cancer in Mali

Objective To conduct the basic information investigation to women in Mali, evaluate the effectiveness of visual inspection with acetic acid(VIA) & visual inspection with Lugol's iodine(VILI) method and cytology method for cervical cancer and cervical intraepithelial neoplasia(CIN), and provide data support and scientific evidence for the improvement of screening techniques. Methods A total of 3 658 cases of women from 2016 to 2018 were selected as screening objects, and 3 638 cases were eligible women. The visual inspection with acetic acid(VIA) & visual inspection with Lugol's iodine(VILI) and the cytology method were respectively performed under double-blind experiment. The colposcopy was conducted in women with a positive result or clinically possible patients for the cervical biopsy. Results Among the 3 638 women who participated in the screening, the age of first sexual intercourse was 18.19±3.26 years old, the number of births was 4.5±3.1, the ratio of polygamy was 50.27%, the education level of primary school or below was 48.87%, and the recognition rate was 13.20%. The detection rate of CINⅡ+ lesions in VIA/VILI group was 4.90%(χ²=14.241, P=0.014), and the detection rate of CINⅡ+ lesions in cytology group was 5.16%(χ²=17.189, P=0.004). Meanwhile, the detection rate of pathological biopsy was 74.53%. Conclusion It is significantly important to strengthen the awareness of cervical cancer prevention knowledge, improve the cognition rate and screening rate of cervical cancer, and standardize screening programs to reduce the morbidity and mortality of cervical cancer in Mali, Africa.