Management algorithms for cervical cancer screening and precancer treatment for resource‐limited settings

Abstract

Management algorithms for screen-positive women in cervical cancer prevention programs have undergone substantial changes in recent years. The WHO strongly recommends human papillomavirus (HPV) testing for primary screening, if affordable, or if not, then visual inspection with acetic acid (VIA), and promotes treatment directly following screening through the screen-and-treat approach (one or two clinic visits). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Impact of operational factors on HPV positivity rates in an HPV‐based screening study in Colombia

“…In several LMICs, screening is recommended through campaigns aiming to screen as many women as possible in a single day. [19][20][21][22] In The present study is one of only a few studies exploring the role of operational factors in the variability of HPV assay performance.…”

“…In several LMICs, screening is recommended through campaigns aiming to screen as many women as possible in a single day . In advance of such campaigns, quality assurance systems should be developed to avoid an increase in the rate of false‐positive results, which could result in an increased number of colposcopy referrals or in increased overtreatment rates if screen and treat strategies are implemented.…”

The investment case for cervical cancer elimination

“…Gaps in evidence on use in low‐resource settings and recommended clinical guidelines should be filled in the next few years. Basu et al . note that several basic management algorithms for handling screen‐positive women have been developed, although evaluation of their use in routine programs is still needed and is a priority going forward.…”

“…Gaps in evidence on use in low-resource se ngs and recommended clinical guidelines should be filled in the next few years. Basu et al15 note that several basic management algorithms for handling screen-posi ve women have been developed, although evalua on of their use in roune programs is s ll needed and is a priority going forward.Broader health system elements and community ac ons provide the essen al underpinnings for clinical programs. Focused and systema c analyses of health informa on systems in recent years have iden fied feasible approaches for incorpora ng cervical cancer indicators into rou ne government data systems, whether paper-based or electronic 16 ; implementa on of these approaches is now the urgent priority.…”

Cervical cancer prevention for all women: Why now?

“…New technology opportunities are emerging in the field of outpatient ablative treatments for precancerous cervical lesions . Basu et al . share the latest thinking on how to combine screening and preventive treatment methods for the optimal balance of effectiveness, acceptability, safety, and feasibility in low‐resource settings.…”