Complex Diagnosis of Cervical Intraepithelial Neoplasia in the Republic of Tajikistan

Abstract

Objective: To study the experience of a comprehensive diagnosis of cervical intraepithelial neoplasia (CIN) based on the results of the first pilot visual screening in the Republic of Tajikistan. Methods: The first pilot visual screening in two large districts of the Republic of Tajikistan was carried out in 2016. A total of 68,391 women of the target groups took part in this study, of which 26,691 (39%) were from the Kushoniyon district and 41,700 (61%) from the B. Gafurov district. According to the algorithm of organized visual screening, extended colposcopy, cytological examination, and biopsy with histological examination were performed. Results: According to the results of the tests performed, in 164 cases (0.24%) CIN was diagnosed, while in 20 cases (0.03%) cervical cancer (CC) was detected (p<0.001). Mild low-grade squamous intraepithelial lesions (LSIL) lesions were detected in 99 cases (70 women from B. Gafurov district and 29 patients from Kushoniyon district), while severe high-grade squamous intraepithelial lesions (HSIL) were detected in 65 cases (59 women from B. Gafurov district and 6 women from Kushoniyon district). Patients with histologically confirmed precancerous pathology and cervical cancer were referred for outpatient and inpatient treatment. Conclusion: The strategy of organized visual screening 'detection-diagnosis-treatment', recommended by WHO for countries with limited resources, is optimal for implementation in the conditions of the Republic of Tajikistan at the national level. Keywords: Cervical intraepithelial neoplasia, visual screening, VIA/VILI visual method, colposcopy.