Using VIA to screen for cervical cancer among HIV-infected women in Tanzania

The association between HIV/AIDS and invasive cervical cancer is complex, with studies demonstrating an increased risk of pre-cancerous cervical lesions and a rapid progression to cancer amongst HIV-infected women.  In HIV-infected women, Human Papilloma Virus (HPV) is detected more frequently and resolves more slowly. Cervical cancer, caused by HPV, is the most common cancer in Tanzania and the leading cause of cancer related deaths among women in the country. Tanzania is among countries with the highest cervical cancer burden in the world, with incidence of 50.9 cases per 100,000 women. This burden is 50% higher than the East African average and nine times higher than Europe and North America. However, if detected early and the pre-cancerous lesions treated, cervical cancer is almost 100% preventable. IMA World Health has been providing cervical cancer screening services in the Mara Region of Tanzania for the last three years. The screening uses Visual Inspection with Acetic Acid (VIA) and Single Visit Approach (SVA). Screening is offered daily and if diagnosed with pre-cancerous cells, women are treated with cryotherapy the same day. This screen-and-treat approach prevents lost to follow-up. Currently, over 6,000 women between 30-40 years of age, and all HIV positive women irrespective of age were screened for cervical cancer using VIA along with cryotherapy treatment. Of those screened, 7% were VIA positive and 3% presented with suspicious or advanced cervical cancer. Providing effective screening methods for early detection of pre-cancerous lesions coupled with early treatment increases chances for survival and a complete cure.