Adequacy of Visual Inspection with Acetic Acid (VIA) in Comparison to Pap Smear for Cervical Cancer Screening in Urban and Rural Settings of Tanzania

Authors

• Crispin Kahesa, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
• Daniela Gonzalez, University of Nebraska-Lincoln, Lincoln, NE
• Kandali Samwel, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
• Duan Loy, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
• Cameron Klein, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
• Abigail Shotwell, University of Nebraska-Lincoln, Lincoln, NE
• Martha Ricaurte, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
• Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
• Brenda B. Kweyamba, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
• Asafu Munema, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
• Monica K. Angeletti, University of Nebraska-Lincoln, Lincoln, NE
• Kessy Godwin, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
• Elayna Brown, University of Nebraska-Lincoln, Lincoln, NE
• Gleb Haynatzki, University of Nebraska Medical Center, Omaha, NE
• Veenu Minhas, AbbVie, North Chicago, IL
• John T. West, LSU Health Sciences Center - New OrleansFollow
• Charles Wood, LSU Health Sciences Center - New OrleansFollow
• Peter C. Angeletti, University of Nebraska-Lincoln, Lincoln, NE

Document Type

Article

Publication Date

8-29-2026

Publication Title

Cancers

Abstract

Tanzania is a low-to-middle-income-country (LMIC) which endures significant adverse impact from HIV-1- and HPV-associated malignancies. We investigated the performance of visual inspection with acetic acid (VIA) compared to the Pap smear. : Screening performance was assessed in a cross-sectional study design across rural catchment clinics in Bagamoyo and Chalinze, and an urban site, Ocean Road Cancer Institute (ORCI), in Dar es Salaam. Pap smears were performed and were read in triplicate by readers blinded to HIV status and patient demographic data. Blood samples were collected for HIV status confirmation.

All cytopathology, VIA, and HIV status data were compared with patient demographic factors. Here we present results from 672 patients. Analysis of participants across the cohort revealed a high rate of HIV (25%) and exchange of "sex for money" in the rural site of Chalinze. Bagamoyo and ORCI had slightly lower HIV rates of about 16% and 12%, respectively. Despite the high HIV rates in Chalinze (25%), there was a contrastingly low-level of detectable lesions by VIA (9%) in this region. : Overall, VIA-positive cases were 26% HSIL-positive, whereas VIA-negative cases were 14% HSIL-positive, suggesting that performance of VIA is limited.

First Page

1

Last Page

17

PubMed ID

42738332

Volume

18

Issue

2811

Publisher

MDPI

Rights

© 2026 by the authors

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Kahesa, Crispin; Gonzalez, Daniela; Samwel, Kandali; Loy, Duan; Klein, Cameron; Shotwell, Abigail; Ricaurte, Martha; Mwaiselage, Julius; Kweyamba, Brenda B.; Munema, Asafu; Angeletti, Monica K.; Godwin, Kessy; Brown, Elayna; Haynatzki, Gleb; Minhas, Veenu; West, John T.; Wood, Charles; and Angeletti, Peter C., "Adequacy of Visual Inspection with Acetic Acid (VIA) in Comparison to Pap Smear for Cervical Cancer Screening in Urban and Rural Settings of Tanzania" (2026). School of Medicine Faculty Publications. 5212.
https://digitalscholar.lsuhsc.edu/som_facpubs/5212
10.3390/cancers18172811