Cervical Cancer Screening Data from the Case-based National Electronic Registry in Bangladesh

Introduction: The purpose of this study is to review the cervical cancer surveillance situation of Bangladeshi women based on the data of the national cervical cancer screening, treatment, and follow-up programme which uses longitudinal data tracking through a DHIS2-based electronic registry. Methods: Women aged 30 to 60 were enrolled in the DHIS2 electronic registry in health facilities of all tiers and screened for cervical cancer using the VIA method. The VIA-positive women had their colposcopy in the nearest colposcopy centres. The VIA- and colposcopy-positive women were treated and followed up at certain intervals following the national standard protocol. During each encounter, required data were captured in DHIS2. Data from the DHIS2 covering January 2018 to May 2023 were extracted and analysed for this study. Results : In 6,895 health facilities, 1,562,963 women were enrolled. Among them, 1,557,002 (99.6%) availed VIA tests at 1,094 centres. Primary healthcare facilities performed 74.4% enrolments and 72% VIA tests. 51,913 (3.3%) women were VIA-positive, of which only 20,954 (40.4%) attended for colposcopy. Among the colposcopy-positive women, 6.3% (1,327) and 6.2% (1,302) women had CIN II/III and cervical carcinoma respectively; 81.6% (5,062) of the cervical pre-cancerous women received thermal ablation and 17.6% (1089) received Loop Electrosurgical Excision Procedure (LEEP). Distribution of histopathology reports (n = 3,079) revealed 16.1% (n = 495) squamous cell carcinoma, 4.0% (n = 123) micro-invasive squamous cell carcinoma, 11.7% (n = 36) CIN II and 8.1% (n = 250) CIN III. Conclusions : The sustainable national cervical cancer screening and treatment programme for women in Bangladesh using an effective DHIS2-based electronic case-based tracking system can be a valuable lesson for other countries.