Screen‐and‐Treat Approach to Cervical Cancer Prevention Using Visual Inspection With Acetic Acid and Cryotherapy: Experiences, Perceptions, and Beliefs From Demonstration Projects in Peru, Uganda, and Vietnam. (11th November 2013)

• Record Type: Journal Article
• Authors: Paul, Proma; Winkler, Jennifer L.; Bartolini, Rosario M.; Penny, Mary E.; Huong, Trinh Thu; Nga, Le Thi; Kumakech, Edward; Mugisha, Emmanuel; Jeronimo, Jose
• Is Part Of: Oncologist. Volume 18:Number 12(2013)
• Page Start: 1278
• Page End: 1284
• Publication Date: 2013-11-11
• Subjects: Cervical cancer -- Cancer screening -- Program evaluation -- Community outreach -- Visual inspection with acetic acid -- Perceptions; Oncology -- Periodicals; Tumors -- Periodicals; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Oncology; Tumors; Neoplasms; Electronic journals; Periodicals; Periodicals; 616.994
• DOI: 10.1634/theoncologist.2013-0253
• Languages: English
• ISSNs: 1083-7159

Abstract

Abstract : Cervical cancer is preventable but continues to cause the deaths of more than 270, 000 women worldwide each year, most of them in developing countries where programs to detect and treat precancerous lesions are not affordable or available. Studies have demonstrated that screening by visual inspection of the cervix using acetic acid (VIA) is a simple, affordable, and sensitive test that can identify precancerous changes of the cervix so that treatment such as cryotherapy can be provided. Government partners implemented screening and treatment using VIA and cryotherapy at demonstration sites in Peru, Uganda, and Vietnam. Evaluations were conducted in the three countries to explore the barriers and facilitating factors for the use of services and for incorporation of screen‐and‐treat programs using VIA and cryotherapy into routine services. Results showed that use of VIA and cryotherapy in these settings is a feasible approach to providing cervical cancer prevention services. Activities that can help ensure successful programs include mobilizing and educating communities, organizing services to meet women's schedules and needs, and strengthening systems to track clients for follow‐up. Sustainability also depends on having an adequate number of trained providers and reducing staff turnover. Although some challenges were found across all sites, others varied from country to country, suggesting that careful assessments before beginning new secondary prevention programs will optimize the probability of success. Abstract : Government partners implemented screening and treatment with visual inspection using acetic acid (VIA) and cryotherapy at demonstration sites in Peru, Uganda, and Vietnam. Evaluations were conducted in the three countries to explore the barriers and facilitating factors for the use of services and for incorporation of screen‐and‐treat programs using VIA and cryotherapy into routine services. Results showed that use of VIA and cryotherapy in these settings is a feasible approach to providing cervical cancer prevention services. Abstract : 摘要 尽管宫颈癌是可预防的疾病，但全世界每年仍然有超过27万名妇女死于宫颈癌，其中多数生活在不具备或者负担不起癌前病变筛查和治疗项目的发展中国家。研究已经证明采用醋酸染色肉眼观察法（VIA）是一种简单、可负担并且敏感的检测，能识别宫颈的癌前改变，以提示进行治疗（如冷冻疗法）。政府合作伙伴在秘鲁、乌干达和越南的示范点采用VIA和冷冻疗法实施筛查和治疗。我们在这三个国家中开展了评估，以探讨所应用的服务及将这些项目纳为常规服务的障碍和促进因素。结果显示VIA和冷冻疗法在这些地区是一种提供宫颈癌预防服务的可行方法。有助于确保项目成功的活动包括动员和教育社区、组织符合妇女日常安排和需要的服务，以及加强随访客户追踪系统。项目的可持续性还依赖于足够数量的受训工作人员及降低其流动性。虽然有一些挑战是所有的示范点都共有的，另有一些则有地域特殊性。这些发现提示在开始新的二级预防项目之前仔细评估将会把成功概率增至最大化。