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Table 2 Cervical screening, diagnosis and treatment of precancerous lesions

From: Cervical cancer prevention in countries with the highest HIV prevalence: a review of policies

Country

Target age group [years]

Specifications for WLHIV

Entry point

Screening method

Available diagnostic procedures

Treatment of precancerous lesions

Botswana

30–49

NR

NR

VIA, Pap smear, HPV DNA

Colposcopy and histopathology

Cryotherapy, LEEP

Eswatini

NR

NR

Integration into existing services recommended

VIA and Pap smear

Histopathologyb

Cryotherapy, LEEP, TAH

Lesotho

25–49

Start at HIV diagnosis; Freq.—1 year

NR

VIA, VILI, Pap smear, HPV DNA testing

Not available

Cryotherapy, cold coagulation, LEEP

Malawi

25–49

Start age 25

21–24 upon request

Freq.—2 years

HIV clinic, SRH

VIA, Pap smear, HPV DNA testing

Histopathology

Cryotherapy, cold coagulation, surgery, LEEP

Mozambique

NR

Screen all ages

Integration of HIV and CC screening services recommended

NRa

Histopathology

Cryotherapy, surgery

Namibia

25–50

Start at age 20

HIV clinics, ANC clinics

VIA, Pap smear, HPV DNA testing

Colposcopy and histopathology

Cryotherapy, LEEP, Thermocoagulation

South Africa

30–55

Screen all ages

Family planning, HIV clinic

LBC, Pap smear, VIA, HPV DNA testing

Histopathology

LEEP, Cryotherapy for low-resource settings

Zambia

30–59

Start age 25

HIV clinic, MCH

VIA

Histopathology

Cryotherapy, LEEP

Zimbabwe

30–49

Start at HIV diagnosis; Freq.—1 year

Family planning, maternity, Gynaecological clinics, HIV clinics

VIAC, Pap smearc

Histopathology

Cryotherapy, LEEP

  1. ANC is Antenatal clinic, MCH is Mother and Child Health clinic, SRH is Sexual and Reproductive Health unit, Freq. is frequency, VIA is Visual inspection with acetic acid, VILI is Visual Inspection with Lugol’s Iodine, LBC is Liquid based cytology, LEEP is Loop electrosurgical excision procedure, LLETZ is Large loop excision of the transformation zone, TAH is Total abdominal hysterectomy NR is Not reported
  2. aVILI, Pap, HPV DNA testing (expert report)
  3. bExpansion of services ongoing
  4. cPap smear mostly done in private health facilities