**1. Introduction**

Globally life expectancy is on the increase and with this an increase in the incidence of age related gynaecological cancers and other related medical conditions. Gynaecological cancers accounted for 19% of the 5.1million estimated new cancer cases in the world with 2.9 million cancer deaths in 2002. (Sarkaranayanan et al, 2006). The essence of screening is to detect disease among healthy population without symptoms of the disease with the primary purpose of reducing the morbidity and mortality with the disease. This has been done with varying success in various countries having designed programmes aimed at reducing the scourge of gynaecological cancers.

The pattern of screening programmes can be divided into two categories namely: opportun‐ istic and organized. The organized screening programmes are mostly observed in the developed countries like Finland, Sweden and the United states of American were specific policy decisions have been taken by the respective Government with the concentration of resources to gynaecological cancer screening with resultant of the population and im‐ proved outcome. Following the implementation of organized screening programmes especially with cervical cancer remarkable reductions in mortality in Nordic countries have been observed with largest fall in Iceland, Sweden and Finland (Laara et al, 1987) con‐ verse is the case in developing countries where most patients have poor health seeking attitude; uninformed and Disempowered population, increasing competing health needs, limited human and material needs, unaffordable treatment for gynecological cancers and lack of political will on the part of the respective governments to create policies that will focus resources on early gynaecological cancer detection(Danny L et al 2006). The econom‐ ics of these countries put a lot of pressure on the limited resources in the face of multiple demand.The average per capital expenditure in many African countries is approximately USD30 compared to USD500 in the United States of `America (Denny L et al, 2005) creating an economic menu for poorly organized screening programmes. Hence screening pro‐

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grammes are largely opportunistic in nature relying on other channels of health care to provide a vehicle for screening like the family planning clinics and STI clinics.

Most female genital tract malignancies have identifiable precursors such as cervical intraepi‐ thelial lesions, vaginal intraepithelial, vulva intraepithelial, atypical endometrial hyperplasia for endometrial cancer while others like ovarian malignancies do not have identifiable precursors making screening modalities non specific. The potential benefits of screening includes early detection of pre invasive cancers and avenue for provision of curative services to patients identified while reassuring those that are negative and rechanneling health resources to other purposes. It must be stated that screening programme have potential limitations of false negative and positive results giving false assurances to affected patients and overtreatment of none affected patients. (Kwawukume et al, 2005)
