Utility of Colposcopy for the Screening and Management of Cervical Cancer in Africa: A Cross-Sectional Analysis of Providers’ Training and Practices

Authors

Joël Fokom Domgue
Issimouha Dille
Freddy Gnangnon
Sharon Kapambwe
Celine Bouchard
Nomonde Mbatani
Elodie Gauroy
Nathalie Ledaga Ambounda
Robert Yu
Fatoumata Sidibe
Joseph Kamgno
Bangaly Traore
Pierre-Marie Tebeu
Gregory Halle-Ekane
Mohenou Isidore Diomande
Jean-Marie Dangou
Fabrice Lecuru
Isaac Adewole
Marie Plante
Partha Basu
Sanjay Shete

Publication Date

12-18-2024

Journal

BMC Health Services Research

DOI

10.1186/s12913-024-11982-1

PMID

39695604

PMCID

PMC11658535

PubMedCentral® Posted Date

12-18-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords

Humans, Female, Cross-Sectional Studies, Colposcopy, Uterine Cervical Neoplasms, Adult, Africa, Early Detection of Cancer, Middle Aged, Health Personnel, Male, Surveys and Questionnaires, Mass Screening, Africa, Cancer prevention, Cervical cancer, Cervical cancer screening, Colposcopy, Early detection, Healthcare providers, Secondary prevention, Transformation zone, Visualization

Published Open-Access

yes

Recommended Citation

Fokom Domgue, Joël; Dille, Issimouha; Gnangnon, Freddy; et al., "Utility of Colposcopy for the Screening and Management of Cervical Cancer in Africa: A Cross-Sectional Analysis of Providers’ Training and Practices" (2024). Faculty, Staff and Student Publications. 3792.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/3792