Lessons Learned From 7 Years of Implementing Cervical Cancer Screening and Treatment in Equatorial Guinea

Area of Science:

• Public Health
• Gynecologic Oncology
• Global Health

Background:

• Cervical cancer remains a significant health burden, particularly in low-resource settings.
• Equatorial Guinea has historically faced challenges in accessing screening and treatment services.
• The single-visit, screen-and-treat approach offers a promising strategy for improving cervical cancer prevention.

Purpose of the Study:

• To evaluate the effectiveness and reach of the Cervical Cancer Screening and Treatment (CCST) project in Equatorial Guinea.
• To compare the performance of facility-based versus community outreach service delivery models.
• To assess the implementation of the single-visit, screen-and-treat approach.

Main Methods:

• The study involved screening 26,998 women aged 20-60 years between 2017 and 2023.
• Visual inspection with acetic acid (VIA) was used for screening, with cold coagulation for treatment.
• Two delivery strategies were employed: in health facilities and through community outreach, supported by training and quality improvement initiatives.

Main Results:

• Both facility-based and community outreach strategies reached comparable numbers of women.
• Community outreach was more effective in reaching women in mainland areas and specific demographic groups (married, younger age at first intercourse, multiparous, postmenopausal).
• The VIA positivity rate was 2.6%, with higher rates in younger women. Treatment was provided to 55% of VIA-positive cases.

Conclusions:

• The CCST project demonstrated the feasibility and effectiveness of both service delivery models in Equatorial Guinea.
• Continued expansion, quality improvement, and capacity transfer to the Ministry of Health are crucial for long-term success.
• This initiative highlights the potential of the single-visit, screen-and-treat approach for cervical cancer prevention in similar settings.