Abstract PO-249: Implementing community cervical mass screenings in low-middle-income countries: A project implemented by the Blueprint for Success Program, International Cancer Institute in Kenya
Authors: Koech Andrew , Achieng Emma , Odoyo Edwin , Munene Dennis , Asirwa Fredrick Chite 
Published: December 2020

Abstract
Background: Cervical cancer ranks the second most common cancer in women living in less developed regions with over 500, 000 new cases in 2018 translating to 84% of the new cases worldwide. In 2018, over 300,000 women died from cervical cancer with more than 85% of these deaths occurring in low- and middle-income countries. This was about 1.0% of the reported new cases and about 1.1% of deaths reported in Kenya. The global health community has for the past decade been progressively emphasizing on the importance of addressing cancer prevention and screening where the disease burden is greatest. In low resource settings, especially most parts of Kenya where cervical screening services are offered, visual inspection of the cervix is widely used since there is limited access to Pap-Smear and HPV-DNA testing due to cost implications. However, Cervical cancer screening has faced tremendous challenges due to cultural beliefs in the communities hence giving an opportunity to fewer women to access this service. This project aimed to emphasize the importance of community cervical screening to increase cancer awareness, early screenings, diagnosis and linkage into care clinics in Meru county, Kenya. Methods: 2608 women between the ages of 13 and 92 years from January to December 2019, from a cervical cancer screening programme supported by Blueprint for success program in Meru county, were evaluated. Women who had a suspicion for abnormalities had biopsies taken and sent to Lancet Kenya Pathological Laboratory for histopathological testing and findings communicated to the International Cancer Institute Care and Research Clinics for follow-up and linkage to care and management. Biopsies were the only form of confirmatory testing for suspected cervical intraepithelial neoplasia grade 2 or higher CIN 2+. Results: The participants who underwent Visual Inspection with Acetic acid had a mean age of 44.87±14.4 years. 7.02% of the women screened were below 25 years, 57.09% between 25 to 49 years and 35.89% above the age of 49 years. All the women screened were educated on the importance of continual screening based on their HIV status. 2.11% HIV+ women were asked to undergo screening yearly, 83.28% HIV- women were encouraged to access screening at least once every three years whereas the 14.61% women who did not know their HIV status were advised to get tested and get screened based on their HIV status outcome. VIA results from 2552(97.85%) women were found to be normal, 43(1.65%) were abnormal or aceto-white while 13(0.05%) had ulcerations and excessive bleeding. Biopsies were taken from 42(1.61%), Loop Electrosurgical Excision Procedure (LEEP) was done for 1(0.04%), and polypectomy was done for 2(0.08%). Conclusion: Community-based mass screenings have improved early screening and encouraged the uptake of screenings in Meru county. Pap smear cytology and HPV-DNA testing confirmatory tests are recommendations for increasing the uptake due to its provision for privacy and handling the cultural beliefs’ challenge.
Citation Format: Andrew Koech, Emma Achieng, Edwin Odoyo, Dennis Munene, Fredrick Chite Asirwa. Implementing community cervical mass screenings in low-middle-income countries: A project implemented by the Blueprint for Success Program, International Cancer Institute in Kenya [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-249.