SCREENING FOR CERVICAL NEOPLASIA IN MAMELODI - LESSONS FROM AN UNSCREENED POPULATION

Aim. To determine the prevalence of abnormal cervical cytological find ings in an unscreened population; to assess patients' awareness of cer vical cancer and the importance of early diagnosis; and to evaluate th e accuracy of visual inspection of the cervix as a screening method fo r asymptomatic cervical cancer. Study structure. Descriptive. Setting. Mamelodi Hospital, a community day hospital east of Pretoria, serving a black urbanised population that had never been exposed to a routine cervical cytological screening programme. Methods. One thousand and n inety-five women of reproductive age, who presented with a non-gynaeco logical complaint, were offered cervical cytological testing and were asked to complete a questionnaire. Visual appreciation of the cervical condition was noted and compared with the cytology report. Results. T he prevalence of abnormal cervical cytological findings (low- and high -grade squamous cervical intraepithelial neoplasia (CIN), excluding hu man papillomavirus-induced cell changes only) was 54/1 000. Only 2% of the patients had a good knowledge of cervical cancer and cervical scr eening. Visual inspection of the cervix detected 4 out of 5 cervical c ancers in this group, but failed to identify those patients with high- grade CIN. Conclusion. This study shows a high prevalence of abnormal cervical cytological findings in a population ignorant about cervical cancer. Recommendations on how to improve this situation are made.