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.