Cervical cancer screening using visual inspection with acetic acid: operational experiences from Ghana and Thailand

Sanghvi, Harshad; Limpaphayom, K; Plotkin, Marya; Charurat, Elaine; Kleine, Amy; Lu, Enriquito; Eamratsameekool, Wachara; Palanuwong, Buncha

doi:10.1016/s0968-8080(08)32401-x

Cited by 50 publications

(57 citation statements)

References 11 publications

(9 reference statements)

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“…With careful training, nurses and midwives in Bangladesh, Ghana, India, Thailand, and South Africa have proven capable of providing cryotherapy safely and effectively (Gaffikin et al, 2003;Denny et al, 2005;Blumenthal et al, 2007;Ahmed et al, 2008;Nene et al, 2008;Sanghvi et al, 2008). These mid-level providers have also been acceptable toand sometimes even preferred by-women receiving cryotherapy (Bradley et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Influencing Women's Actions on Cervical Cancer Screening and Treatment in Karawang District, Indonesia

Kim

Ati²,

Kols

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Introduction: The impact of cervical cancer prevention programs depends on persuading women to go for screening and, if needed, treatment. As part of an evaluation of a pilot project in Indonesia, qualitative research was conducted to explore the factors that influence women's decisions regarding screening and treatment and to generate practical recommendations to increase service coverage and reduce loss to follow up. Methods: Research was conducted at 7 of the 17 public health centers in Karawang District that implemented the pilot project. Interviews and focus group discussions were held with 20 women, 20 husbands, 10 doctors, 18 midwives, 3 district health officials, and 16 advocacy team members. Results: Free services and mobile outreach events encouraged women to go for screening, along with promotional efforts by community health workers, advocacy teams, and the mass media. Knowledge and perceptions were the most important barriers to screening: women were not aware of cervical cancer risks, did not know the disease was treatable, and were fatalistic. Factors facilitating treatment were social support from husbands, relatives, and friends and the encouragement and role modeling of health workers. Barriers to prompt treatment included limited access to services and the requirement for husband's consent for cryotherapy. Conclusion: As cervical cancer prevention services are scaled up throughout Indonesia, the findings suggest three strategies to expand screening coverage and ensure prompt treatment: strengthening community mobilization and advocacy activities, modifying the service delivery model to encourage a single visit approach to screening and treatment, and working to gain men's support.

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Section: Discussionmentioning

confidence: 99%

Influencing Women's Actions on Cervical Cancer Screening and Treatment in Karawang District, Indonesia

Kim

Ati²,

Kols

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…VIA can be task-shifted to lower level health workers and, most notably, allows single visit screening and treatment. Furthermore, VIA has been shown to be safe, feasible and acceptable in multiple studies (Phongsavan et al 2011;Palanuwong 2007;Sanghvi et al 2008). The positive predictive value of VIA is low and fairly common conditions such as cervicitis may cause false positive VIA results (Davis-Dao 2008).…”

Section: Alternatives To Cervical Cytologymentioning

confidence: 99%

Cervical Cancer Screening and Prevention for HIV-Infected Women in the Developing World

Anderson¹,

Lu²,

Sanghvi³

et al. 2012

Cancer Prevention - From Mechanisms to Translational Benefits

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“…Most studies of secondary prevention in low-and middleincome countries have focused on the accuracy of VIA [5][6][7][8][9][10][11], although a few have explored feasibility and acceptability [12][13][14]. In the present study, government partners collaborated with PATH, an international nongovernmental organization, in Peru, Uganda, and Vietnam, to implement demonstration projects for screening and treatment of precancerous lesions.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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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 andcryotherapyintoroutineservices.Resultsshowedthatuseof 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. Althoughsomechallengeswerefoundacrossallsites,othersvaried from country to country, suggesting that careful assessments before beginning new secondary prevention programs will optimize the probability of success. The Oncologist 2013;18: 1278 -1284 Implications for Practice: Government-run cervical cancer screening programs in Peru, Uganda, and Vietnam showed that using visual inspection with acetic acid (VIA) and cryotherapy in these settings is a feasible approach to providing cervical cancer prevention services. Activities that can help to ensure success 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. While some challenges were found across all three countries, others varied, suggesting that careful assessments before beginning new secondary prevention programs will optimize the probability of success.

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Cervical cancer screening using visual inspection with acetic acid: operational experiences from Ghana and Thailand

Cited by 50 publications

References 11 publications

Influencing Women's Actions on Cervical Cancer Screening and Treatment in Karawang District, Indonesia

Influencing Women's Actions on Cervical Cancer Screening and Treatment in Karawang District, Indonesia

Cervical Cancer Screening and Prevention for HIV-Infected Women in the Developing World

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

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