Isaakidis, P

Khim, S A

Kim, C

Martello, L

Ping, C

Raguenaud, Marie-Eve

Reid, Tony

English

MSF Field Research

XVII INTERNATIONAL
AIDS CONFERENCE
3-8 August 2008 | Mexico City
Poster Discussion Session 
THPDB2 - Highlighting issues for women in clinical research, treatment and care  
 
THPDB205 - Cervical cancer screening among HIV-positive women in rural Cambodia: a pilot programme  
 
M.-E. Raguenaud1, P. Isaakidis1, S.A. Khim1, C. Ping2, C. Kim3, L. Martello4, T. Reid5 
  
1Médecins Sans Frontières OCB, Phnom Penh, Cambodia, 2RHAC, Phnom Penh, Cambodia, 3Médecins Sans Frontières 
OCB, Takeo, Cambodia, 4Médecins Sans Frontières OCB, Siem Reap, Cambodia, 5Médecins Sans Frontières OCB, 
Brussels, Belgium 
  
Issues: Cervical cancer is the most common malignancy among women in Cambodia. Since HIV+ women tend to 
have persistent Human Papillomavirus infection they are at higher risk for cervical cancer than the general population. To 
help plan a nationwide screening programme in Cambodia that is at its early development, a pilot screening 
programme targeting HIV+ women was conducted in one HIV clinic, aiming at early detection and treatment of 
cervical abnormalities.  
Description: A referral system was set-up between the HIV clinic and a near-by reproductive health clinic. HIV clinic 
doctors systematically referred all female patients for PAP-test screening until a total of 100 women was 
reached. Transportation to the reproductive health clinic was provided on the same day as the HIV consultation. 
After screening, follow up and referral for biopsy and treatment, as necessary, were organized by the HIV clinic staff.  
Lessons learned: In a period of 2½ months, 100 women were screened, representing 14% of all HIV-positive women 
enrolled in the programme. Pre-cancer lesions / cervical cancer were common among women screened. 25 women 
had confirmed LSIL or HSIL on PAP-test and 22 of them underwent biopsy. 2 had endocervicitis, 19 had pre-cancerous 
lesions (CIN1-3), and one had carcinoma in-situ. All patients with pre-cancerous lesions or cancer were referred for 
either cryotherapy or hysterectomy. One woman died and 2 women were lost to follow-up. This good record is most likely 
due to the well established recall system of the HIV clinic, the involvement of the HIV clinic doctors, and the support 
for transportation.  
Next steps: Our pilot programme indicated that there is a high yield in offering cervical cancer screening to HIV+ women, 
that it is feasible and can be integrated into HIV care where there is access to diagnosis and treatment. This is 
encouraging information for the planned nationwide screening programme.    
Presenting author email: msfb-phnom-penh-med@brussels.msf.org 

Cervial cancer screening among HIV-positive women in rural Cambodia: a pilot programme

Cervial cancer screening among HIV-positive women in rural Cambodia: a pilot programme

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