Title : Evaluation of the cervical cancer surveillance system in Abidjan, Côte d'Ivoire from 2019 to 2023

Abstract:

Introduction:
Cervical cancer (UCC) is a significant public health concern. In 2022, it was the eighth most common cancer worldwide, with an incidence rate of 14.1 per 100,000 women. In Côte d'Ivoire, it was the third most common cancer, accounting for 11.1% of all cancers. Côte d'Ivoire aims to eliminate UCC by implementing a surveillance system through the Abidjan Cancer Registry (ACR) and the District Health Information System 2 (DHIS2). This study is the first evaluation of the UCC surveillance system in Abidjan.

Methods:
A descriptive cross-sectional study was conducted in Abidjan. The survey covered health professionals at all three levels of the health pyramid. The ACR and DHIS2 were used. The surveillance system's functions and attributes, such as usefulness, simplicity, acceptability, responsiveness, and data quality, were described. Data were analyzed using Excel and IBM SPSS Statistics 27. After performing normality testing, the mean and standard deviation of age were calculated. Categorical variables were expressed as percentages. The results were presented in tabular and graphical form. Ethical considerations were taken into account.

Results:
The survey was carried out at 83% of the planned sites and with 80% of the planned participants. The average age of these participants was 45, and the female-to-male ratio was 1.89. Sixty-seven point three percent of participants were at the operational level. Midwives represented 44.2% of the professions.
Eighty-seven percent of participants considered screening for precancerous cervical lesions to be straightforward, and 76.9% agreed that surveillance activities should be routine. The system was neither stable nor responsive. However, the data quality was acceptable. The system was useful in 88.5% of UCC cases.

Conclusion:
The UCC surveillance system is functional and useful, and the data quality is acceptable. However, it is neither simple nor stable, nor is it reactive. It would be improved if the support functions were strengthened.