scholarly journals Hands-On Training Courses for Cervical Cancer Screening, Diagnosis, and Treatment Procedures in Low- and Middle-Income Countries

2022 ◽  
Author(s):  
Natacha Phoolcharoen ◽  
Melissa Lopez Varon ◽  
Ellen Baker ◽  
Sonia Parra ◽  
Jennifer Carns ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Cancer Prevention ◽  
Diagnosis And Treatment ◽  
Middle Income ◽  
Middle Income Countries ◽  
Hands On ◽  
Training Courses ◽  
Treatment Procedures

In 2018, there were approximately 570,000 new cases of cervical cancer worldwide. More than 85% of cases occurred in low- and middle-income countries (LMICs), primarily because of poor access to screening and a limited number of medical providers trained to diagnose and treat cervical precancerous lesions. Our objective was to provide locally arranged, hands-on training courses for medical providers in LMICs to learn to perform cervical cancer screening, diagnosis, and treatment procedures. The courses included didactic lectures and hands-on training stations using low-cost simulation models developed by bioengineers and students at Rice University in Houston, TX, United States, and the Malawi Polytechnic in Blantyre, Malawi. The hands-on training stations included visual inspection with acetic acid (VIA), colposcopy, cervical biopsy, endocervical curettage, loop electrosurgical excision procedure (LEEP), and thermal ablation. Provider pre- and postcourse confidence levels in performing the procedures were evaluated. From February 2017 to January 2020, we arranged 15 hands-on training courses in seven cities across six countries (El Salvador, Mozambique, Trinidad and Tobago, Lesotho, Malawi, and Nepal). Overall, there were 506 participants. The average number of participants per course was 38 (range 19-92). The participants included doctors, nurses, and midwives. The course duration varied from 1 to 3 days. Increased confidence in performing VIA, colposcopy and cervical biopsy, ablation, and LEEP was reported by 69%, 71%, 61%, and 76% of participants, respectively. Our findings suggest that locally arranged, hands-on cervical cancer prevention training courses in LMICs can improve provider confidence in performing cervical cancer screening, diagnosis, and treatment procedures. These courses are part of a larger strategy to build local capacity for delivering and improving cervical cancer prevention services in LMICs.

'Have a Pap smear!' – doctors, their clients, and opportunistic cervical cancer screening

2005 ◽  
Vol 16 (3) ◽  
pp. 233-236 ◽  
Author(s):  
L C Chingang ◽  
U Bischof ◽  
G Andall-Brereton ◽  
O Razum
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Cervical Screening ◽  
Pap Test ◽  
Community Members ◽  
Middle Income ◽  
Middle Income Countries ◽  
High Incidence

In many middle-income countries with a high incidence of cervical cancer, organized screening programmes with the Pap test are being planned. We assessed the knowledge of, and attitudes towards, cervical screening among 63 doctors and 102 randomly selected community members in Trinidad where screening is still opportunistic. Doctors were well informed about cervical cancer, but not all knew the approximate specificity of the Pap test. Many did not routinely discuss the benefits and disadvantages of screening with their clients. Most women had heard of the Pap test, but only 56% knew its purpose; 25% would not participate in screening, stating reasons such as being in menopause or not having symptoms. More information about the aim of screening and the purpose of the Pap test must be communicated. Doctors need to keep their knowledge on screening up-to-date, and offer counselling that helps women to make an informed decision whether or not to participate in screening.

Clinical trial to implementation: Cost and effectiveness considerations for scaling up cervical cancer screening in low- and middle-income countries

2016 ◽  
Vol 7 ◽  
pp. 4-11 ◽  
Author(s):  
Sujha Subramanian ◽  
Rengaswamy Sankaranarayanan ◽  
Pulikkottil Okkuru Esmy ◽  
Jissa Vinoda Thulaseedharan ◽  
Rajaraman Swaminathan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Scaling Up ◽  
Implementation Cost ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Cervical Cancer Screening and HPV Vaccination

2021 ◽  
pp. 61-67
Author(s):  
Richard Fielding ◽  
Samara Perez ◽  
Zeev Rosberger ◽  
Ovidiu Tatar ◽  
Linda D. L. Wang
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Psychological Impact ◽  
Middle Income ◽  
Public Health Burden ◽  
Middle Income Countries ◽  
Screening Strategies ◽  
Successes And Challenges

Cervical cancer kills 300,000 women annually, despite being among the most preventable of all cancers, with a well-known cause (human papilloma virus [HPV]), established and successful screening strategies, and effective vaccination and treatments. This chapter examines the reasons for this inconsistency and begins by outlining the epidemiology and public health burden of cervical cancers. It describes HPV vaccine–related successes and challenges in low- and middle-income countries contrasted with high-income countries, with emphasis on the two most populous countries of India and China, before examining issues around strategies for cervical cancer screening in high- and low-resource settings. Following discussion of screening recommendations, the chapter describes barriers and facilitators to vaccination, screening, and testing. It then addresses screening and vaccination messaging and the psychological impact of testing and concludes with future directions.

scholarly journals Mobile Technologies and Cervical Cancer Screening in Low- and Middle-Income Countries: A Systematic Review

2020 ◽  
pp. 617-627 ◽  
Author(s):  
Dongyu Zhang ◽  
Shailesh Advani ◽  
Jo Waller ◽  
Ana-Paula Cupertino ◽  
Alejandra Hurtado-de-Mendoza ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Test ◽  
Mobile Telephone ◽  
Mobile Technologies ◽  
Middle Income ◽  
Screening Uptake ◽  
Middle Income Countries

PURPOSE Cervical cancer screening is not well implemented in many low- and middle-income countries (LMICs). Mobile health (mHealth) refers to utilization of mobile technologies in health promotion and disease management. We aimed to qualitatively synthesize published articles reporting the impact of mHealth on cervical cancer screening–related health behaviors. METHODS Three reviewers independently reviewed articles with the following criteria: the exposure or intervention of interest was mHealth, including messages or educational information sent via mobile telephone or e-mail; the comparison was people not using mHealth technology to receive screening-related information, and studies comparing multiple different mHealth interventional strategies were also eligible; the primary outcome was cervical cancer screening uptake, and secondary outcomes included awareness, intention, and knowledge of screening; appropriate research designs included randomized controlled trials and quasi-experimental or observational research; and the study was conducted in an LMIC. RESULTS Of the 8 selected studies, 5 treated mobile telephone or message reminders as the exposure or intervention, and 3 compared the effects of different messages on screening uptake. The outcomes were diverse, including screening uptake (n = 4); health beliefs regarding the Papanicolaou (Pap) test (n = 1); knowledge of, attitude toward, and adherence to colpocytologic examination (n = 1); interest in receiving messages about Pap test results or appointment (n = 1); and return for Pap test reports (n = 1). CONCLUSION Overall, our systematic review suggests that mobile technologies, particularly telephone reminders or messages, lead to increased Pap test uptake; additional work is needed to unequivocally verify whether mhealth interventions can improve knowledge regarding cervical cancer. Our study will inform mHealth-based interventions for cervical cancer screening promotion in LMICs.

scholarly journals Cost-effectiveness of cervical cancer screening methods in low- and middle-income countries: A systematic review

2017 ◽  
Vol 141 (3) ◽  
pp. 437-446 ◽  
Author(s):  
Alex K. Mezei ◽  
Heather L. Armstrong ◽  
Heather N. Pedersen ◽  
Nicole G. Campos ◽  
Sheona M. Mitchell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Screening Methods ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals High Acceptability of Human Papillomavirus Self-Sampling Among Nonattenders of a Public Cervical Cancer Screening Program in El Salvador

2018 ◽  
Vol 4 (Supplement 1) ◽  
pp. 13s-13s
Author(s):  
Mauricio Maza ◽  
Mario Melendez ◽  
Miriam Cremer ◽  
Rachel Masch ◽  
Todd Alonzo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
El Salvador ◽  
Cancer Prevention ◽  
Cervical Cancer Screening ◽  
Rural Women ◽  
Cervical Cancer Prevention ◽  
Middle Income ◽  
Hpv Test

Abstract 29 Purpose In high-income countries, human papillomavirus (HPV) self-sampling has been demonstrated to increase adherence to cervical cancer prevention initiatives in underscreened women. El Salvador recently completed the Cervical Cancer Prevention in El Salvador (CAPE) program using a high-risk HPV test as the screening method. Although successful, 12% of targeted women did not attend their screening appointments. HPV self-sampling may offer the opportunity to reach these nonattending women. In the current study, we evaluated HPV self-sampling as a way to increase screening among CAPE nonattenders and to report factors that impact self-sampling acceptability in a low- to middle-income country. Methods Nonattending and underscreened women age 30 to 59 years from the Paracentral region of El Salvador were invited to participate (N = 2,019). Women were visited at home and offered self-sampling with an HPV test. Women who provided consent also received a series of questionnaires to collect demographic and test acceptability data. After tests were analyzed, women were provided with results during another home visit. HPV-positive women were asked to make an appointment at a local clinic to undergo colposcopy, biopsy, and, if eligible, cryotherapy treatment. Women with contraindications for cryotherapy were referred to appropriate treatment or follow-up. Results Of 1,989 eligible women, 94% accepted the HPV self-sampled test. Of these, 11.8% (n = 221) tested positive. All but 13 women attended the colposcopy appointment, and 190 women received cryotherapy. Biopsy results revealed low-grade precancer in 6.3% of women, whereas 12.6% received diagnoses of high-grade precancer. Reasons for not attending the original CAPE appointment included logistic concerns, but also discomfort with male providers, confidentiality fears, and misconceptions regarding HPV, cervical cancer, and the screening procedure. Conclusion HPV self-sampling was shown to be overwhelmingly acceptable to nonattending and underscreened rural women in El Salvador. This method may be a feasible alternative that circumvents barriers to cervical cancer screening in low- to middle-income countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors

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