Effectiveness of cryotherapy treatment for cervical intraepithelial neoplasia

Luciani, Silvana; Gonzales, Miguel; Muñoz, Sergio; Jerónimo, José; Robles, Sonia

doi:10.1016/j.ijgo.2007.11.013

Cited by 52 publications

(46 citation statements)

References 14 publications

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“…24 In this study, the therapy was provided by general physicians, but midwives or other midlevel providers have performed the procedure in other settings with similar results. For example, in Dindigul district in India, Sankaranarayanan et al 25 found an overall cure rate of 81% among women with CIN 1 and 71% among women with CIN 2-3 when cryotherapy was provided by nurses in field clinics.…”

Section: Alternative Cervical Cancer Screening Approaches In Low-resomentioning

confidence: 94%

Evidence-Based, Alternative Cervical Cancer Screening Approaches in Low-Resource Settings

Sherris¹,

Wittet²,

Kleine³

et al. 2009

IPSRH

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105

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Cervical cancer kills approximately 270,000 women worldwide each year, with nearly 85% of those deaths occurring in resource-poor settings. 1 Use of the Pap smear for routine screening of women has resulted in a dramatic decline in cervical cancer deaths over the past four decades in wealthier countries. A key reason for continuing high mortality in the developing world is the shortage of efficient, high-quality screening programs in those regions.In 1999, five international health organizations came together to create the Alliance for Cervical Cancer Prevention (ACCP).* For the next eight years, with support from the Bill & Melinda Gates Foundation, the partners worked on a coordinated research agenda aimed at assessing a variety of approaches to cervical cancer screening and treatment (especially ones that may be better suited to low-resource settings), improving service delivery systems, ensuring that community perspectives and needs are incorporated into program design, and increasing awareness of cervical cancer and effective prevention strategies. Several outstanding issues were identified at that time. A general issue was a lack of consensus about the most effective and feasible options for improving cancer screening and treatment. Specific issues included uncertainty about the impact of simple screening methods and a screen-and-treat approach on cervical cancer incidence and mortality; the comparative performance of visual inspection methods of screening-visual inspection with acetic acid (VIA) or Lugol's iodine (VILI) † -and new methods using human papillomavirus (HPV) DNA testing; the optimal ways to reduce false-positive results from visual inspection methods without producing more false-negatives; and any possible links between the use of cryotherapy and subsequent HIV acquisition.Recent studies and analyses have answered some of these questions and have validated earlier findings related to safe, effective, operationally feasible and culturally appropriate strategies for secondary prevention of cervical cancer. ‡ On the basis of these new data and the results of earlier research conducted in 20 African, Asian and Latin American countries, the ACCP partners have summarized and shared key findings and recommendations for effective cervical cancer screening and treatment programs in low-resource settings, as follows. FINDINGS•In low-resource settings, the optimal age-group for cervical cancer screening to achieve the greatest public health impact is 30-39-year-olds. Screening is considered optimal when the smallest amount of resources is used to achieve the greatest benefit. To determine the optimal age for cervical cancer screening, ACCP researchers used two methodologies: modeling and field-based study. Goldie et al. 2 conducted cost-effectiveness modeling comparing screening strategies in five developing countries. Their model predicted that for 35-year-old women screened only once in their life, a single-visit or two-visit approach with the VIA method could reduce the lifetime risk of cervical canc...

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Section: Alternative Cervical Cancer Screening Approaches In Low-resomentioning

confidence: 94%

Evidence-Based, Alternative Cervical Cancer Screening Approaches in Low-Resource Settings

Sherris¹,

Wittet²,

Kleine³

et al. 2009

IPSRH

Self Cite

105

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“…This inexpensive and technically simple technique destroys abnormal tissue by freezing it with a probe cooled by liquid carbon dioxide (CO 2 ). A systematic review of 32 studies found that the procedure is safe and has an overall cure rate of almost 90% (Castro et al, 2003), and more recent studies have confirmed its effectiveness Luciani et al, 2008;Chamot et al, 2010).…”

Section: Introductionmentioning

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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“…5 Demonstration projects and randomized controlled screening trials have found that the effectiveness and efficiency of a single visit screen-and-treat strategy using VIA testing followed by treatment with cryotherapy are high. [6][7][8] VIA has sensitivity equal to or greater than the Pap test in detecting high-grade dysplasia, requires simple equipment, and provides immediate results. Cryotherapy is also more appropriate for low resource settings, as it does not rely on electricity and is inexpensive.…”

Section: Introductionmentioning

confidence: 99%

Bolivian Health Providers' Attitudes Toward Alternative Technologies for Cervical Cancer Prevention: A Focus on Visual Inspection with Acetic Acid and Cryotherapy

Stormo

Altamirano

Pérez-Castells

et al. 2012

Journal of Women's Health

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Background-Little is known about health providers' attitudes toward visual inspection with acetic acid (VIA) and cryotherapy in the prevention of cervical cancer, as most research in Latin America and the Caribbean (LAC) has examined attitudes of the general population. This study describes attitudes of Bolivian health professionals toward new technologies for cervical cancer prevention, focusing on VIA and cryotherapy.

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Effectiveness of cryotherapy treatment for cervical intraepithelial neoplasia

Abstract: Cryotherapy is an effective treatment for cervical precancerous lesions; it can easily be administered by general practitioners in primary care settings following visual inspection screening.

Cited by 52 publications

References 14 publications

Evidence-Based, Alternative Cervical Cancer Screening Approaches in Low-Resource Settings

Evidence-Based, Alternative Cervical Cancer Screening Approaches in Low-Resource Settings

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

Bolivian Health Providers' Attitudes Toward Alternative Technologies for Cervical Cancer Prevention: A Focus on Visual Inspection with Acetic Acid and Cryotherapy

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