Evaluation of effectiveness, acceptability and safety of thermal ablation in the treatment of cervical neoplasia in Burundi. Issue 7 (3rd June 2022)

• Record Type: Journal Article
• Authors: Sauvaget, Catherine; Bazikamwe, Sylvestre; Lucas, Eric; Ndayikengurukiye, Athanase; Harerimana, Salvator; Barango, Prebo
• Is Part Of: International journal of cancer. Volume 151:Issue 7(2022)
• Page Start: 1120
• Page End: 1126
• Publication Date: 2022-06-03
• Subjects: cervical neoplasia -- LMIC -- thermal ablation -- treatment; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.34117
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: This longitudinal study aimed at evaluating the effectiveness, acceptability and safety of the thermal ablation procedure (TA) in the treatment of cervical neoplasia. Women referred to the Gynaecology ward for symptoms or for opportunistic screening were assessed by visual inspection with acetic acid (VIA) and colposcopy. Those with lesions eligible to ablation were counselled and treated by TA. They were inquired about the level of pain during the procedure, and their level of satisfaction. Patients were followed up at 6 weeks for any complication and reassessed by VIA and colposcopy at 12 months for any persistent or recurrent lesion and for any adverse event. A total of 86 women with a positive VIA test were included in the study. The mean age was 46 years (28‐61 years). Most of the women did not complain about any adverse event during treatment; one‐third presented mild pain or cramp. At the 6‐week visit, watery discharge was the main adverse event reported. All women were highly satisfied with TA and most of them would recommend it. At the 12‐month visit, 82 women were examined (95% follow‐up rate), and the overall cure rate was 96% (low‐grade lesions: 98%; high‐grade lesions: 94%). Three women presented low‐ and high‐grade lesions that were treated by TA. No major adverse event or hospitalisation after the treatment was reported. In conclusion, TA was an effective procedure with a high cure rate at the 1‐year follow‐up visit. It was acceptable and safe, with only minor short‐term side‐effects reported and with a high satisfaction rate among the patients. Abstract : What's new? Cervical cancer remains a major public health issue in resource‐constrained settings. Appropriate management of precancer lesions is a key strategy to achieve cervical cancer elimination. Many low‐income countries provide cryotherapy as an ablative treatment, but thermal ablation may be a more practical and sustainable alternative. This longitudinal study reports the efficacy of thermal ablation in the treatment of cervical neoplasia in Burundi. Thermal ablation had a high cure rate at 12 months and was found to be safe and acceptable, supporting its potential use at the primary health care level in a 'screen‐and‐treat' approach.