Using A New Hand - Held Colposcope In Combination With Cryotherapy And Leep In A See - And - Treat Cervical Cancer Screening Program

Objectives: To screen and treat women in a low-resource area of the Amazon basin in Peru for cervical cancer using a hand-held digital colposcope and compare the colposcopic impressions and histologic diagnoses.Methods: Descriptive study of 250 Peruvian women who presented for visualization with acetic acid (VIA) screening in the Amazon basin during October 2017. Screening was performed using a digital handheld colposcope system, with biopsies collected and analyzed for those who were thought to have cervical dysplasia on colposcopic impression. The primary outcome was the congruence between colposcopic impression and pathologic diagnosis on cervical biopsy.Results: 250 women were screened. 30 women screened positive during colposcopy. Of the 20 women who were suspected of having low-grade dysplasia, 15 had CIN 1 and 5 were negative for dysplasia (75% congruent, CIN1). Of the 6 women suspected of having high-grade dysplasia, 1 had cervicitis, 2 had CIN2, and 3 had CIN3 (83.3% congruent, CIN2-3). Of the 4 women suspected of having invasive carcinoma, 3 had invasive cancer and one had severe cervicitis (75% congruent, cervical carcinoma).Conclusion: Digital colposcopy can optimize cervical cancer screening in low resource settings, as it can yield a relatively high congruence between colposcopic impressions and histologic diagnosis.