TITLE:
Evaluation of Screening Tests for Precancerous and Cancerous Lesions of the Cervix in a Resource-Limited Country: The Case of the Health District of Commune V of Bamako, Mali, 2024
AUTHORS:
Traoré Soumana Oumar, Bocoum Amadou, Kanté Ibrahim Ousmane, Sima Mamadou, Kouma Aminata, Sissoko Abdoulaye, Fané Seydou, Traoré Alassane, Samaké Alou, Tall Saoudatou, Doumbia Saleck, Diakité Nouhoun, Dembélé Fousseyni, Théra Tiounkany, Tégueté Ibrahim, Traoré Youssouf, Mounkoro Niani
KEYWORDS:
Screening, Cervical Lesions, Uterus, Visual Inspection, Cervical Smear, Cervical Cancer
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.15 No.12,
December
16,
2025
ABSTRACT: Introduction: The validity of Visual Inspection with Acetic Acid (VIA) and Visual Inspection after Lugol’s Solution (VIL), as well as cervical smears (CFS) or cervical-vaginal smears (CVS), in screening for cervical lesions of the uterus has been the subject of numerous studies worldwide. The Objective of this study was to evaluate the performance of these tests, comparing them to the results of biopsy/histology, for the detection of cervical lesions in the health district of Commune V of Bamako, Mali. Methods: This was a cross-sectional, descriptive, and analytical study with prospective data collection. The study aimed to evaluate the results of colorimetric tests (IVA/IVL) and cervical smears (Pap smears). We included sexually active women, aged 25 to 49 years, who were not pregnant, not menopausal, and had not undergone a total hysterectomy, who were undergoing their first screening for precancerous lesions with a positive IVA/IVL (one or both tests) and an abnormal Pap smear. Data analysis was performed using SPSS 20 software. Results: A total of 8,517 patients were screened, of whom 1,272 (14.90%) had abnormalities on the IVA/IVL smear, and 1,237 (14.50%) showed abnormalities on the urinalysis. Among these abnormalities, 88 (6.90%) were carcinomas. The mean age of the patients was 33.16 years, with an age range of 25 to 49 years. The majority of the women screened were married (69.18%), had had few pregnancies (35.14%), had had few children (35.10%), were educated (67.25%), and were civil servants (35.43%). Regarding visual inspection tests, the IVA/IVL showed a sensitivity (Se) of 87%, a specificity (Sp) of 89%, a positive predictive value (PPV) of 89%, and a negative predictive value (NPV) of 87%, with an estimated true prevalence of the disease (PRM) of 50%. As for the cervical smear (FCU), we found a sensitivity (Se) of 87%, a specificity (Sp) of 90%, a positive predictive value (PPV) of 89%, and a negative predictive value (NPV) of 88%, with a true prevalence of the disease (PRM) of 48%. Conclusion: Visual inspection methods (VIA/VIA) demonstrate performance comparable to that of the cervical smear (CAP) in detecting precancerous and cancerous cervical lesions. These results suggest that VIA/VIA could be an effective alternative to the CAP for screening for cervical lesions, particularly in resource-limited settings.