CERVICAL CYTOLOGY STUDY IN PORT-VILA, VANUATU

Vanuatu's reported incidence of cervical cancer mortality in 1988-1989 was 5-7 per 100,000 women. The majority of women born in Vanuatu (ni- Vanuatu) are of Melanesian extraction. Cervical cancer was the most co mmon cancer in Melanesian women (25% of all cases). The mean age at pr esentation was 45 years. Cervical screening was not available. This pa per reports on the prevalence of cervical abnormalities and reproducti ve tract infections (RTI) found on regular testing at Antenatal Clinic s (ANC) and Outpatient/Emergency Clinics (ODP) at Vila Central Hospita l and evaluates the feasibility of a screening programme. A total of 7 77 Melanesian women were screened with cytology completed in New Zeala nd and New Caledonia. Eighty five percent of the slides were adequate. Of the 34 women with abnormal smears, four had carcinoma in situ (CIS ) and 13 women had Human papillomavirus (HPV). Severe inflammatory rea ction was reported in 33% of smears and 77% of these were in pregnant women. Within the group showing severe inflammatory reaction 36% had T richomonas vaginalis (TV). Overall there was a 17% incidence of TV. Th e incidence of cervical cellular changes in this sample of highly sele cted Melanesian women having first time smears was higher than expecte d. An ongoing cervical screening programme could not be economically s ustained in 1989. The unexpectedly high rates of treatable RTI promote d continuation of routine microbiological testing at ANC.