Rikerdy Frederic, MD, Division of Community Health, Hospital Albert Schweitzer, 10 Rue Clercine Cizeau, Port au Prince, Haiti, 509.274.2771, rikerdyfred@yahoo.fr and Melissa Ann Osmond, MPH, Student Success and Wellness, Lewis & Clark College, 0615 SW Palatine Hill Rd, MSC 182, Portland, OR 97219.

Objective: To develop an understanding of the prevalence of abnormal cervical lesions among women of reproductive age in the Hospital Albert Schweitzer (HAS) service district, and to investigate options for cervical cancer screening programs in area.

Methods: Between February 2001 and April 2002, a PAP screening pilot project was conducted by three OB/GYN physicians at the outpatient clinic in the hospital at HAS. Specimens were sent to Piedmont Hospital in Atlanta, GA for analysis. Results were returned to HAS. Women between the ages of 18 and 50, many of whom were pregnant, were screened. Women with abnormal results were contacted and treated accordingly.

Results: A total of 584 smears were screened and 105 (18%) were abnormal; 475 were normal; and 4 could not be read. Of those 105 abnormal results, 26 (25%) were diagnosed with high-grade squamous intraepithelial lesion (HSIL) (three of which had carcinoma), while 31 (30%) were considered low-grade (LSIL). A total of 30 of these women were diagnosed with HPV (7 with HSIL, and 23 with LSIL). Infection, atypical squamous cells of undetermined significance (ASCUS), and benign cellular changes accounted for the 48 remaining abnormal results.

Conclusions: Results reveal a high prevalence of abnormal tests among the sexually active women in the district. Considering that cervical cancer prevention is more effective than treatment, this indicates a need for a routine cervical cancer-screening program. As HAS does not have the resources to continue cytological screening, alternative methods such as visual inspection with acetic acid (VIA) are being explored.

Learning Objectives: