A Community-Based Cervical Cancer Screening Initiative in Guinea: A Retrospective Descriptive Study of Service Delivery and Outcomes

Background: Cervical cancer remains a major public health challenge in Guinea, where no organized national screening program exists. Community-based initiatives led by civil society organizations represent a critical access point for prevention services in this context. This study aimed to evaluate the programmatic outcomes of a community-based cervical cancer screen-and-treat program in Guinea. Methods: We conducted a retrospective, cumulative cross-sectional analysis of routinely collected data over 37 months (October 2019–October 2022) at the Aminata Souaré Screening Center in Conakry. Cervical screening was performed using VIA/VILI, followed by colposcopy and immediate treatment with thermal ablation or LEEP for eligible women, in accordance with WHO screen-and-treat recommendations. Primary outcomes included screening reach, positivity rates, treatment coverage, and retention. Results: A total of 2,392 women underwent cervical cancer screening, of whom 79.05% were first-time participants. VIA and VILI positivity rates were 6.23% and 6.61%, respectively. All 158 VILI-positive women underwent colposcopy; 36.08% had lesions suggestive of precancerous disease, and 2.53% showed features consistent with invasive cancer. Among eligible women, 85.96% received thermal ablation and 8.77% underwent LEEP, yielding a treatment coverage of 94.73%. Loss to follow-up was 5.26%. Among the 17 women with available histology, 8 had CIN2+ lesions confirmed. Conclusion: This community-based screen-and-treat program demonstrated operational feasibility, high treatment coverage, and strong retention in a resource-limited urban setting. These findings provide operational evidence to inform the development and scale-up of cervical cancer prevention strategies in Guinea.