Digital camera assessment for detection of cervical intraepithelial neoplasia in rural El Salvador.

OBJECTIVE To explore the feasibility of digital photography for primary cervical cancer screening in a low-resource setting in El Salvador. METHODS Three independent examiners performed Pap test, visual inspection, digital camera assessment and colposcopy on each subject. RESULTS Lesions were detected in 99 of 504 patients (20%) by visual inspection, 72/504 (14%) by DART and 90/504 (18%) by colposcopic impression. Seven of 504 patients (1.3%) had CIN on histology. Pap detected 2 of 7 subjects (29% sensitivity) (C.I. 4%, 56%), visual inspection detected 5 of 7 (71% sensitivity, C.I. 34%, 95%), digital assessment detected 6 of 7 (86% sensitivity C. I. 45%, 99%), and colposcopic impression detected 5 of 7 (71% sensitivity, C.I. 34%, 95%). CONCLUSION This small pilot trial demonstrates the potential value and feasibility of performing digital camera assessment of the reproductive tract on women in a developing country setting.