Cervical Screening Using Visual Inspection with Acetic Acid (VIA) and Treatment with Cryotherapy in Fiji

The purpose of this study was to demonstrate the feasibility of VIA screening with cryotherapy and to recordnormative values for indicators anticipated in similar low resource settings. Women aged 30-49 years weretargeted, resulting in 1961 women screened and treated at two primary health care (PHC) centres near Suva,Fiji. Recruitment was through provision of information, education and communication (IEC). Referrals to agynaecology outpatient department (OPD) at a referral hospital occurred throughout the screening pathway.Participation was 32% (95%CI 31-33%), higher in iTaukei (Melanesians) women (34%, 95%CI 33-36) comparedto Fijians of Indian descent (26%, 95%CI 24-28). Regression analysis, adjusted for confounders, indicatedsignificantly lower participation in those of Indian descent, and age groups 35-39 and 45-49 years. Of thoseexamined by VIA, 190 were positive with aceto-white lesions (9.9%), within the expected range of 8-15%, withminor geographic and ethnic variation. Positive VIA results were more common in the peri-urban area, andin those aged 35-39 years. Of women aged 30-49 years, 59 received cryotherapy (none of whom had significantcomplications), 91 were referred to OPD, two cervical carcinomas were identified and eight cervical intra-epithelialneoplasms (CIN) II-III were diagnosed. These results provide normative findings from a community-based VIAscreening program for other similar low resource settings.