Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 5;19(1):454.
doi: 10.1186/s12913-019-4314-8.

Utilization and outcomes of cervical cancer screening services in Harare City, 2012-2016: a secondary data analysis

Christine Gabaza  1 , Prosper Chonzi  2 , Addmore Chadambuka  1 , Gerald Shambira  1 , Tsitsi Patience Juru  3 , Notion Tafara Gombe  1 , Peter Nsubuga  4 , Mufuta Tshimanga  1
Affiliations

Utilization and outcomes of cervical cancer screening services in Harare City, 2012-2016: a secondary data analysis

Christine Gabaza et al. BMC Health Serv Res. .

Abstract

Background: Visual inspection with acetic acid and cervicography (VIAC) is a method used to screen for cervical cancer. VIAC can be used as part of a "see and treat" strategy. Nine Harare city council health facilities offer VIAC free of charge with the aim of reducing morbidity and mortality from cervical cancer. Between 2014 and 2016, the number of women utilising VIAC dropped by 35%. We analysed records of clients who utilise VIAC at Harare city health facilities to characterise women accessing VIAC and their outcomes to make recommendations for improving the services.

Methods: We conducted a descriptive cross-sectional study using data collected for the Harare city VIAC program. We analysed all records of clients who utilised VIAC services at nine Harare city health facilities from 1 May 2012 to 31 December 2016.

Results: We analysed 46,217 records, the median age of the clients was 34 years [Q1 = 27: Q3 = 42]. Of the 46,217 clients screened, 3001 (6.5%) were VIAC positive, and 512 (1.1%) had suspicious of cancer lesions. The prevalence of VIAC positive ranged from 58 to 74 per 1000-screened clients over the 5 years. The prevalence of suspected cancer ranged from 9 to 14 per 1000-screened clients, and there was a general decrease in the prevalence between 2012 and 2016. Of the 3513 clients with VIAC positive or had suspicious of cancer lesions, 2090 (74.1%) did not receive treatment at the site where the screening took place.

Conclusion: The majority of women who are accessing VIAC services in Harare are middle-aged, multiparous and married women. There is a treatment gap at most of the VIAC centres such that clients are referred to other centres for management. The objective of "see and treat" is not being realised.

Keywords: Cancer screening; Cervical cancer; VIAC; Zimbabwe.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Prevalence of precancerous cervical lesions by year among VIAC clients, Harare city, 2012–2016
Fig. 2
Fig. 2
Proportions of clients presenting for VIAC with gynaecological symptoms Harare City, 2012–2016
Fig. 3
Fig. 3
Management given to clients with VIAC positive or suspicious of cancer results, Harare City 2012–2016
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. GLOBOCAN Cancer Fact Sheets: Cervical cancer [internet]. [cited 2018 may 21]. Available from: http://globocan.iarc.fr/old/FactSheets/cancers/cervix-new.asp.
    1. Zimbabwe National Cancer Registry. Cancer Profile In Zimbabwe [Internet]. [cited 2017 Aug 21]. Available from: http://www.zimcancerregistry.co.zw/cancer-profile-in-zimbabwe.html.
    1. WHO | Comprehensive cervical cancer control [Internet]. [cited 2017 Aug 27]. Available from: http://www.who.int/reproductivehealth/publications/cancers/cervical-canc...
    1. World Health Organization | Human papillomavirus (HPV) and cervical cancer [Internet]. WHO. 2017 [cited 2017 Aug 28]. Available from: http://www.who.int/mediacentre/factsheets/fs380/en/
    1. Chirara M, Bergstrom S, Nzara MJ, Stanczuk GA, Tswana SA, Nzara MJ, et al. Low risk and high risk human papillomaviruses (HPVs) and cervical cancer in Zimbabwe: Epidemiological evidence. 2001 [cited 2017 Aug 29]; Available from: http://ir.uz.ac.zw/xmlui/handle/10646/2934. - PubMed