Fokom Domgue Joël, Dille Issimouha, Gnangnon Freddy, Kapambwe Sharon, Bouchard Celine, Mbatani Nomonde, Gauroy Elodie, Ambounda Nathalie Ledaga, Yu Robert, Sidibe Fatoumata, Kamgno Joseph, Traore Bangaly, Tebeu Pierre-Marie, Halle-Ekane Gregory, Diomande Mohenou Isidore, Dangou Jean-Marie, Lecuru Fabrice, Adewole Isaac, Plante Marie, Basu Partha, Shete Sanjay
Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, 1400 Pressler Dr., FCT4.6002, Houston, TX, 77030, USA.
Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
BMC Health Serv Res. 2024 Dec 18;24(1):1619. doi: 10.1186/s12913-024-11982-1.
Cervical cancer is a public health issue in Africa with devastating socioeconomic consequences due to the lack of organized screening programs. The success of screening programs depends on the appropriate investigation and management of women who test positive for screening. Colposcopic assessment following positive screening results is a noteworthy issue in Africa. This study aimed to assess the utilization of colposcopy by providers in the region.
A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior colposcopy training, whether they performed colposcopy and the indications of colposcopy in their practice.
Of the 130 providers from 23 African countries who responded to the survey (mean age [SD]: 39.0 years [9.4]), half were female (65 [50.0%]), and 90.7% reported working in urban areas. Overall, only 12.6% of respondents indicated having received prior training on colposcopy, and 11.7% reported that they were performing colposcopy in their current practice. Among the providers who reported performing colposcopy in their practice, colposcopy was indicated for routine cervical cancer screening in 21.2% of clinicians, to better visualize the transformation zone in 15.2% of respondents, to further assess the vascularization of cervical mucosa in 33.3% of respondents, and to determine the appropriate treatment modality in 12.1% of respondents. Providers who performed colposcopy in their practice reported a median number of 30 (interquartile range: 19-65) colposcopic procedures in the past 6 months.
Providers' training and practice of colposcopy for cervical cancer screening remain suboptimal in Africa. To increase utilization of colposcopy in the region, further training is needed to improve providers' knowledge and engagement. With the development of lower-cost and portable colposcopes, efforts to equip cervical cancer prevention programs and facilities with colposcopy should be enhanced to ensure that women can be screened and managed appropriately in the clinical setting and communities.
宫颈癌是非洲的一个公共卫生问题，由于缺乏有组织的筛查项目，它会带来毁灭性的社会经济后果。筛查项目的成功取决于对筛查呈阳性的女性进行适当的检查和管理。筛查结果呈阳性后的阴道镜评估在非洲是一个值得关注的问题。本研究旨在评估该地区医疗服务提供者对阴道镜的使用情况。
2021年至2022年，对参与非洲宫颈癌预防活动的医疗服务提供者进行了一项横断面研究。邀请他们报告以前接受过的阴道镜培训情况、是否进行阴道镜检查以及他们在实践中进行阴道镜检查的指征。
在回复调查的来自23个非洲国家的130名医疗服务提供者中（平均年龄[标准差]：39.0岁[9.4]），一半为女性（65名[50.0%]），90.7%报告在城市地区工作。总体而言，只有12.6%的受访者表示曾接受过阴道镜培训，11.7%报告他们目前在实践中进行阴道镜检查。在报告在实践中进行阴道镜检查的医疗服务提供者中，21.2%的临床医生进行阴道镜检查是为了进行常规宫颈癌筛查，15.2%的受访者是为了更好地观察转化区，33.3%的受访者是为了进一步评估宫颈黏膜的血管化情况，12.1%的受访者是为了确定合适的治疗方式。在实践中进行阴道镜检查的医疗服务提供者报告说，在过去6个月中，他们进行阴道镜检查的中位数为30次（四分位间距：19 - 65）。
在非洲，医疗服务提供者在宫颈癌筛查方面的阴道镜培训和实践仍未达到最佳水平。为了提高该地区阴道镜的使用率，需要进一步培训以提高医疗服务提供者的知识水平和参与度。随着低成本便携式阴道镜的发展，应加强努力为宫颈癌预防项目和设施配备阴道镜，以确保女性能够在临床环境和社区中得到适当的筛查和管理。
