Elimination of cervical cancer in low‐ and middle‐income countries: Inequality of access and fragile healthcare systems

Vale, Diama Bhadra; Teixeira, Júlio César; Bragança, Joana Fróes; Derchain, Sophie; Sarian, Luís Otávio; Zeferino, Luíz Carlos

doi:10.1002/ijgo.13458

Cited by 33 publications

(29 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The estimated age-standardized incidence of cervical cancer is 13•1 per 100 000 women globally and varies widely among countries (1). Compared with 40 years ago, the morbidity of cervical cancer has decreased due to the established screening program and available vaccines for human papilloma virus (HPV) in many countries, however, advanced cervical cancer cases remain prevalent, especially in developing countries (2). Currently the international standard treatment for advanced cervical cancer is platinum-based chemoradiotherapy (3).…”

Section: Introductionmentioning

confidence: 99%

Concurrent Chemoradiotherapy With Nedaplatin Versus Cisplatin in Patients With Stage IIB-IVA Cervical Cancer: A Randomized Phase III Trial

Wang

Lai

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundIn this trial, we aimed to assess the efficacy and safety of radiotherapy with nedaplatin or cisplatin in patients with locally advanced cervical cancer.MethodsWe conducted an open-label, non-inferiority, phase III, randomized, controlled trial. Eligible patients with stage IIB-IVA cervical carcinoma were randomly assigned to receive either nedaplatin or cisplatin for two cycles concurrently with radiotherapy. We reported the therapy-associated harms and survival. The study was registered with chictr.org.cn, number ChiCTR1800020527.ResultsWe randomly assigned 68 patients to nedaplatin-based or cisplatin-based concurrent chemoradiotherapy. Study treatment was stopped early after a data analysis found a higher number of patients suffered severe hematologic harms in the nedaplatin group than in the cisplatin group. Patients in the nedaplatin group had a significantly higher frequency of grade 3-4 neutropenia (19·4% vs. 13%; P < 0·001), severe thrombocytopenia (16·1% vs. 4·3%), and grade 1-2 anemia (51·6% vs. 43·5%) than patients in the cisplatin group. The 1-year PFS and OS in the nedaplatin and cisplatin groups were similar.ConclusionOur findings showed that nedaplatin-based concurrent chemoradiotherapy expressed remarkably higher severe hematologic harms which were mortal. Though the results were negative, the experiences and lessons we learned from it were important.

show abstract

Section: Introductionmentioning

confidence: 99%

Concurrent Chemoradiotherapy With Nedaplatin Versus Cisplatin in Patients With Stage IIB-IVA Cervical Cancer: A Randomized Phase III Trial

Wang

Lai

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Low income countries face higher difficulty due to financial limitations and higher burden of CC and still have room for improvement. Adequate targeting of infrastructure, geographical inaccessibility, structured time-management in clinics, patient education and effective communication between provider and patient, combination of vaccination and screening, analysing and improving screening programmes could offer considerable improvement in screening in vulnerable countries ( 84 ).…”

Section: Barriers To Screening In Low Resource Countries and Strategi...mentioning

confidence: 99%

Cervical cancer, geographical inequalities, prevention and barriers in resource depleted countries (Review)

2022

View full text Add to dashboard Cite

Cervical cancer (CC) remains a current global issue, with >90% of cervical cancer cases being attributed to human papilloma virus (HPV). The highest burden of cervical cancer is reported in resource-depleted geographical areas with a high incidence of HPV infection. Recent developments in primary prevention include vaccinations against specific strains of HPV and the psychoeducation of the public. Yet, despite the availability of vaccinations, there is high incidence of both HPV and cervical cancer in developing countries, which is attributed to a multitude of barriers including inaccessibility to expensive vaccines. With regards to secondary prevention, progress is actively being made to develop more effective methods of screening and to specifically address the needs of low-income countries. In the past few years, more novel screening methods, such as self-assessment kits, immunohistochemistry and methylation marker analysis, have been developed. Barriers to screening in resource-depleted countries include limited financial resources and infrastructure to develop screening programmes, a lack of screening programmes that are accessible to populations, inadequate training of healthcare teams and stigma related to medical examinations performed as part of screening. Developing primary and secondary prevention programs, as well as addressing the barriers involved in countries with low socioeconomic levels, can drastically reduce morbidity and mortality rates associated with cervical cancer, thus reducing the burden associated with this gynaecological malignancy. Contents1. Introduction 2. Epidemiology and geographical inequalities in the burden of CC 3. Primary prevention and barriers faced by developing countries 4. Vaccinations 5. Psychoeducation 6. Secondary prevention and challenges faced by developing countries 7. Recent developments in screening methods 8. Barriers to screening in low resource countries and strategies for improvement 9. Conclusion

show abstract

“…2,3 According to the World Health Organization (WHO), eliminating cervical cancer depends on multiple efforts, including prevention through vaccination, screening and treatment of precursor lesions, and treatment and palliative care for invasive cervical cancer. 4,5 There is a consensus that cervical cancer screening is more effective when based on human papillomavirus (HPV) DNA tests over longer intervals. 6,7 In 2016, Instituto Nacional do Câncer (INCA, the Brazilian National Cancer Institute) updated its guidelines for cervical cancer screening.…”

Section: Introductionmentioning

confidence: 99%

Cervical Cancer Screening with HPV Testing: Updates on the Recommendation

Carvalho

Bragança

Derchain

et al. 2022

Rev Bras Ginecol Obstet

Self Cite

View full text Add to dashboard Cite

The present update is a reassessment of the 2018 ‘Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil’ (Zeferino et al.)9, according to the changes observed in new international guidelines and knowledge updates. The most relevant and recent guidelines were assessed. Questions regarding the clinical practice were formulated, and the answers considered the perspective of the public and private sectors of the Brazilian health system. The review addressed risk-based strategies regarding age to start and stop screening, the use of cytology and colposcopy to support management decisions, treatment, follow-up strategies, and screening in specific groups, including vaccinated women. The update aims to improve the prevention of cervical cancer and to reduce overtreatment and the misuse of HPV testing.

show abstract

Elimination of cervical cancer in low‐ and middle‐income countries: Inequality of access and fragile healthcare systems

Cited by 33 publications

References 34 publications

Concurrent Chemoradiotherapy With Nedaplatin Versus Cisplatin in Patients With Stage IIB-IVA Cervical Cancer: A Randomized Phase III Trial

Concurrent Chemoradiotherapy With Nedaplatin Versus Cisplatin in Patients With Stage IIB-IVA Cervical Cancer: A Randomized Phase III Trial

Cervical cancer, geographical inequalities, prevention and barriers in resource depleted countries (Review)

Cervical Cancer Screening with HPV Testing: Updates on the Recommendation

Contact Info

Product

Resources

About