Prospective validation are needed to validate their relevance.Mixed Colors produces a color noise map. They can be used as surrogate markers to identify women who need cervix neoplasm detection. These parameters can be used to reinforce primary prevention. In a chaste society like Madagascar, obtaining information about sexual history is difficult. History of non-specific genital infection was associated with cervical neoplasm (55.36% vs 39.88%, p=0.043) in univariate analysis but was not retained on multivariate analysis. Fruit and vegetables more than 500 grams per day significantly decreased risk by 0.34-fold (p=0.008).

In multivariate analysis, knowledge about the human papillomavirus, abortion and intercourse during menstruation increased risk respectively by 8.14-fold (p=0.001), 2.58- fold (p=0.003) and 2.38-fold (p=0.015). Data were collected on excel 2007 and analyzed on STATA/IC 13.1. Questionnaire containing 16 parameters about socio-cultural and factors, reproductive history and medical history were filled by face-to-face interview. Controls were women without cervical neoplasm. It was a case-control study conducted in 2015 in the four centres of Antananarivo including Malagasy informed and consented women. In order to assess the usefulness of dedicated epidemiological study to optimize the primary prevention, we aimed to assess parameters associated with cervix neoplasm. Only few centres actually performed screening using visual inspection with acetic acid.

Human papilloma virus vaccination is under assessment. Access to adequate treatment is difficult for many patients. Madagascar is a low-income island where cervix neoplasm is frequent diagnosed at an advanced stage.

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