Effectiveness, safety and acceptability of ‘see and treat’ with cryotherapy by nurses in a cervical screening study in India

Sankaranarayanan, Rengaswamy; Rajkumar, R; Esmy, Pulikottil Okkuru; Fayette, Jean Marie; Shanthakumary, S; Frappart, Lucien; Somanathan, Thara; Cherian, Jacob

doi:10.1038/sj.bjc.6603633

Cited by 140 publications

(167 citation statements)

References 7 publications

(8 reference statements)

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“…23 Similarly, most ACCP studies have shown extremely low rates of serious adverse events requiring hospitalization, with the most common side effects being fever, pain, watery discharge, bleeding and cramping. 20,25,26 Data from a study conducted by Denny et al 20 in South Africa further confirm the safety of this therapy. Among the almost 950 women who underwent cryotherapy after an initial positive HPV DNA or VIA test, only one experienced a serious adverse event (a woman who refused hospitalization for cervical bleeding).…”

Section: Alternative Cervical Cancer Screening Approaches In Low-resomentioning

confidence: 64%

“…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: 99%

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

Sherris¹,

Wittet²,

Kleine³

et al. 2009

IPSRH

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: 64%

Section: Alternative Cervical Cancer Screening Approaches In Low-resomentioning

confidence: 99%

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

Sherris¹,

Wittet²,

Kleine³

et al. 2009

IPSRH

105

View full text Add to dashboard Cite

show abstract

“…46,47 In a study of nearly 80,000 women in India aged 30-59 screened with VIA, there was a 25% reduction in cervical cancer incidence and 35% reduction in cancer deaths, as compared to a control group that was not screened. Benefits were most marked for women in their 30s.…”

Section: Making Screening and Pre-cancer Treatment Accessiblementioning

confidence: 99%

Making the case for cervical cancer prevention: what about equity?

Tsu¹,

Levin

2008

Reproductive Health Matters

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“…R Sankaranarayanan and colleagues from India, concluded that 'see and treat' with cryotherapy by nurses under medical supervision is acceptable, safe and effective method for cervical cancer prevention in low-resource settings. 5 Mariategui J and co-workers have stated that CO2-cryotherapy may be less effective than N2O-cryotherapy for complete destruction of cervical precancerous lesions. 12 In present study, the age of the patients varied between twenty to forty years.…”

mentioning

confidence: 99%

Cryotherapy for cervical lesions: efficacy and patient satisfaction

Katakdhond

Samant

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Vaginal discharge is a distressing commonplace gynecological condition seen in all age groups albeit from different causes. This study evaluates the outcome of cryotherapy on benign cervical lesions over a period of 2 years in a tertiary care centre. Efficacy of cryotherapy in making patient symptom free. Efficacy of cryocauterization in healing the cervical lesion.Methods: This is prospective observational study of 30 women of reproductive age group attending outpatient department for complaint of vaginal discharge. Cervical cytology was performed for all women and out of the women advised cryotherapy, those fitting inclusion criteria and consenting for study were enrolled. Their findings and investigations were noted. After they underwent cauterization, they were followed for period of 3 months. Findings, complications and level of satisfaction were noted down.Results: Healing of cervical lesion was complete in 96% women at the end of 12 weeks. There was 1 failure of therapy among sample size of 30. Satisfaction rate was high.Conclusions: Cervical cryocauterization is a cheap, effective and simple procedure for treatment of cervical lesions. There are few complications and patient satisfaction is high. It is an easily accessible and safe procedure and helps preserve fertility of women at the same time addressing the vaginal discharge.

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Effectiveness, safety and acceptability of ‘see and treat’ with cryotherapy by nurses in a cervical screening study in India

Cited by 140 publications

References 7 publications

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

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

Making the case for cervical cancer prevention: what about equity?

Cryotherapy for cervical lesions: efficacy and patient satisfaction

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