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Simon M Manga,1– 3 Ling Shi,1 Thomas K Welty,2 Rosanna F DeMarco,1 Teri Aronowitz1 1College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA; 2Cameroon Baptist Convention Health Services, Bamenda, Cameroon; 3Center for Women’s Reproductive Health, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USACorrespondence: Simon M Manga Tel +237 671863768Email smanga@cbchealthservices.orgPurpose: Treatment of cervical precancer is the primary aim in secondary prevention of cervical cancer. The purpose of this study was to examine factors associated with treatment uptake among women with acetic acid/Lugol’s iodine positive lesions identified by digital cervicography (DC) in a cervical cancer prevention program in Cameroon.Patients and Methods: We conducted a cross-sectional survey of medical records from 2013 to 2018 of 755 women in Cameroon who screened positive with acetic acid/Lugol’s iodine in 2013.Results: Of the 755 women, 422 (55.9%) had treatment/biopsy on the same day or followed up later, but only 344 (45.6%) received treatment/biopsy and 333 (44.1%) were lost to follow-up. Overall, 180 (52.3%) of the 344 women were treated/biopsied the same day they were screened, and 164 (47.7%) were treated/biopsied after the initial visit. Women aged 30– 49 and HIV-positive women were significantly more likely to have received treatment or returned for treatment than women less than 30 and HIV-negative women. Of the 266 women who followed up at a later date, the lesions of 78 (29.3%) women regressed spontaneously without treatment. Women with low-grade lesions, HIV-negative women and women who had follow-up more than a year after the initial exam were significantly more likely to have spontaneous regression with regression rates of 30.6%, 32.1% and 62.2%, respectively (p< 0.001). Age was not a significant determinant of spontaneous regression (p=0.149).Conclusion: Efforts to increase treatment uptake are needed in this population, including adherence to same day “See and treat” policies.Keywords: cervical precancer, treatment uptake, cameroon, cryotherapy, thermal ablation, loop electrosurgical excision procedure

Simon Manga,1,2 Edith Kiyang,1 Rosanna F DeMarco2 1Women’s Health Program, Cameroon Baptist Convention Health Services, Bamenda, Cameroon; 2College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA Purpose: This pilot study explores the barriers to adherence to follow-up among women with cervical precancer in urban Cameroon. While follow-up of women with a positive screening of cervical precancer is the most important aspect of cervical cancer secondary prevention, women with cervical precancer do not adhere frequently to recommended follow-up schedule in Cameroon. The aim of the study was to explore and describe the barriers and facilitators to follow-up for cervical precancer among women infected and uninfected with HIV in Cameroon. Participants and methods: A qualitative research design was used to answer the research questions. Participants included eight HIV-infected and -uninfected women diagnosed with cervical precancer and 19 nurses. Data were collected by in-depth individual patient interviews and focus groups with nurses. An interview guide with open-ended questions, using the social ecological model as a framework, included questions that addressed the complexities of the lives of individuals and professionals within a relational context. The interviews were audio-taped and transcribed verbatim in English language. Thematic analysis of data was completed with no epistemological or theoretical perspective underpinning the analyses. Results: Four major themes emerged from the study. They were clinic, personal, and social barriers, and strategies to improve follow-up. Conclusion: The use of reminder phone calls and fee reduction, coupled with peer counseling and navigation of women who have been diagnosed with cervical precancer, could be effective ways of improving adherence to follow-up. Further research is needed to explore the same phenomenon among women in rural areas, especially those who were initially attended to in mobile clinics. Keywords: cervical precancer, follow-up, HIV-infected women, HIV-uninfected women