The cervical cancer is the second most common cancer in women after the breast cancer in Morocco. Recorded 14,3/100 000P-Yrs, it’s diagnosed generally in very late stages, therefore delaying and complicating their therapeutic care. To cope this problem, Morocco undertook progressively a screening program using visual inspection of the cervix with acetic acid as a screening tool in primary health centers, by trained doctors, midwifes, and nurses. Colposcopy and/or directed biopsy were performed on VIA positive Women in specialized centers named reference center for reproductive health. Treatment by loop electrosurgical excision procedure was offered to those with cervical intraepithelial neoplasia. This program initiated towards the end of 2010-early 2011 in only one region in the country and scaled up to 6 regions by 2014.
The aim of this paper is to document the process and the result of a VIA screening program in the province of Meknes, Morocco from 2011 to 2013.
A retrospective study was carry out in 43 health centers and the reference center for reproductive health of the province, based in the following of VIA positive women detected in primary health centers. The data were extracted from the women records and the registry of the program.
During this period, 18 586 women underwent VIA screening, which represents 6 % of participation rate. Among them, 1743 (9,3%) women were positive, of whom 539 (31%) received colposcopy. 64 women were diagnosed with TAG1-2 and one woman with invasive cancer. 23% the women with TAG1/2 lesions had treatment.
This result highlights VIA screening program is useful alternative in low-resource setting, but requires careful and continuous monitoring and implementation of quality assurance. We need also to develop a strategy of community awareness, to increase access to the test and/or treatment.
Cervical cancer, screening program, visual inspection with acetic acid, Morocco