Cervical cancer: Evolving prevention strategies for developing countries

Bishop, Amie; Wells, Elisa; Sherris, Jacqueline; Tsu, Vivien; Crook, Barbara

doi:10.1016/0968-8080(95)90160-4

Cited by 37 publications

(21 citation statements)

References 3 publications

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“…Other possible cervical cancer risk factors include early childbearing, high parity, tobacco use, use of oral contraceptives, genital schistosomiasis and nutritional factors such as low intake of vitamins A, C, E, carotenoids and folate. 7,8 Some of the other cervical cancer risk factors identified are closely interrelated, making it difficult not only to assess the relative importance of these factors but also to know whether they have an independent effect. Both genital HPV and HIV are STIs and may interact, but the nature of such interaction has not been determined.…”

Section: Human Papilloma Virus and Other Risk Factorsmentioning

confidence: 99%

Prevention of Cervical Cancer in Africa: A Daunting Task?

Walraven¹

2003

African Journal of Reproductive Health

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Africa has a high estimated incidence of cervical cancer, thus requiring the development of an effective prevention strategy. Cytology-based screening is beyond the capacity of many African countries, hence the need for alternatives. Visual inspection of the cervix after application of 3-5% acetic acid (VIA) is a promising screening test, with similar sensitivity to that of cytology but lower specificity. The same accounts for other VIA methods using magnification devices, visual inspection after the application of Lugol's iodine, or human papilloma virus (HPV) DNA testing, all proposed alternatives to cervical cancer prevention screening tests. Vaccination against HPV is the most promising strategy for the prevention of cervical cancer, but a wider variety of HPV types than currently being investigated must be considered for the development of the multivalent vaccine preparations required in Africa. Other considerations in developing an effective prevention programme include full public sector investment and achieving acceptability of a vaccine against a sexually transmitted infection targeted for adolescents. Unfortunately, however, if HPV vaccines are developed the initial impact of prophylactic vaccines will be delayed for many years. Alternative strategies should, therefore, be promoted in parallel. There are several approac hes to cervical cancer prevention and their evaluation should be comprehensive and coordinated to achieve short and long-term public health benefits in different programme settings. RÉSUMÉPrévention du cancer du col en Afrique: une tâche intimidante? Il y a une haute incidence estimée du cancer du col, exigeant ainsi l'élaboration d'une stratégie de prévention efficace. Le dépistage à base cytologique est au-dessus de la capacité de bien de pays africains, ce qui justifie la nécessité des alternatifs. L'inspection visuelle du col suite à l'application de 3-5% d'acide acétique (IVA) demeure un test de dépistage prometteur dont la sensitivité est identique à celle de la cytologie, mais qui a une spécificité plus faible. Voilà ce qui justifie les autres méthodes IVA qui se servent des mécanismes de grossissement de l'inspection visuelle suite à l'application de la solution de Lugol ou du virus de papillome humain (VPH), du test d'ADN, tous les alternatifs aux tests de dépistage pour la prévention du cancer du col qui ont été proposés. La vaccination contre le VPH est la stratégie la plus prometteuse pour la prévention du cancer du col, mais il faut étudier une plus grande variété de types VPH pour mieux développer la production polyvalente des vaccins dont a besoin en Afrique. D'autres considérations à l'égard de l'élaboration d'un programme efficace de la prévention comprennent un investissement dans le secteur public et le succès au niveau de l'acceptabilité d'un vaccin contre une infection sexuellement transmissible qui vise les adolescents. Malheureusement, pourtant, si les vaccins VPH sont élaborés, l'impact initial des vaccins prophylactiques sera retardé pour beaucoup d'ànn...

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Section: Human Papilloma Virus and Other Risk Factorsmentioning

confidence: 99%

Prevention of Cervical Cancer in Africa: A Daunting Task?

Walraven¹

2003

African Journal of Reproductive Health

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“…A raised prevalence of epithelial cell abnormality reflects the lack of awareness among people about cervical cancer screening programme. [8,13]Seeing to this it becomes the duty of every governmental and non-governmental agency to sensitize the mass regarding this preventable cancer of cervix.…”

Section: Discussionmentioning

confidence: 99%

“…This may be attributed to the absence of an efficient cervical cancer screening system in the developing countries. [8,13] Cervical smears have become a valuable tool in screening for cervical lesions even at rural peripheral centres because of its easy availability, cost effectiveness, sensitivity, specificity and reliability.…”

Section: Introductionmentioning

confidence: 99%

Uterine Cervical Smear Patterns In Females Attending A Teaching Hospital In Rural Eastern Uttar Pradesh, INDIA.

Bhattacharya¹,

Agarwal²,

Dwivedi³

et al. 2016

IOSR

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“…They also showed that adolescent with an age range of 13-22 had a significantly higher rate of LSIL. 11,12 Another study in Brazil, where 1822441 Pap smears were examined over a period of five years, showed that low grade lesions were common at 15-30 years. Patients older than 40 years had the greatest incidence of invasive cancer.…”

Section: Discussionmentioning

confidence: 99%

Present potential of exfoliative cytology in detection of cervix cancer

Jain¹,

Paudel²,

Jain³

2013

J Lumbini Med Coll

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Introduction: Conventional Pap smear is the mainstay for cervical cancer screening in developing countries and women should be motivated for cervical screening program to detect early dysplastic cells. This study was carried out to find out the prevalence of abnormalities in Pap smears, particularly pattern of epithelial cell abnormality in women attending Lumbini Medical College in western Nepal. Methods: A cross-sectional study was carried out and 1066 Pap smears were studied to look for epithelial cell abnormality according to revised Bethesda system 2001. Results: Out of 1066 patients who underwent Pap smear examination, 71 (6.6%) revealed epithelial cell abnormality; most were low grade squamous intra-epithelial lesions (LSIL) occupying 4.59% at the age between 23 to 29 years. Squamous cell carcinoma was found in 0.37 % of patients at the age 40 years and above. In our scenario, per vaginal discharge was the major finding of the patients who showed premalignant features. Conclusions: Women above 40 years are at a risk of premalignant as well as malignant lesions and these women should undergo screening for abnormal cells at the age of 18 or when sexual activity starts and as per recommendations to look for early dysplastic cells. Cervical screening program should be motivated by the national policy makers and also by health professionals.

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Cervical cancer: Evolving prevention strategies for developing countries

Cited by 37 publications

References 3 publications

Prevention of Cervical Cancer in Africa: A Daunting Task?

Prevention of Cervical Cancer in Africa: A Daunting Task?

Uterine Cervical Smear Patterns In Females Attending A Teaching Hospital In Rural Eastern Uttar Pradesh, INDIA.

Present potential of exfoliative cytology in detection of cervix cancer

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