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Chapter-15 Cervical Cancer Screening of Women in Low Resource Setting

BOOK TITLE: Cytology and Colposcopy in Gynecological Practice

Author
1. Saraiya Usha B
2. Patel Madhuri A
3. Amin Geetanjali
ISBN
9788184485844
DOI
10.5005/jp/books/10194_15
Edition
1/e
Publishing Year
2009
Pages
8
Author Affiliations
1. Sir HN Hospital, Saifee Hospital and Breach Candy Hospital, Mumbai, India, Cama and Albless Hospital, Mumbai, India; CT Hsu Orator 2002 in Bangalore, FIGO 2003, India for Journal of Obstetrics and Gynaecology and Research (AOFOG Journal), Bangladesh Institute of Cancer Research, Indian College of Obstetricians and Gynaecologists, Breach Candy Hospital, Saifee Hospital, Mumbai, Maharashtra, India; FOGSI (2002); ICOG (2006–2009); Grant Medical Hospital, Mumbai, Maharashtra, India, Mumbai, Cama and Albless Hospital, Mumbai, India, Sir. H.N. Hospital, Mumbai, Sir H.N. Hospital, Mumbai, International Expert of National Institute of Cancer Research, Dhaka, Bangladesh, Sir HN Hospital, Saifee Hospital and Breach Candy Hospital, Mumbai, India; Cama and Albless Hospital Mumbai, India; CT Hsu Orator 2002 in Bangalore; FIGO 2003, India for Journal of Obstetrics and Gynaecology and Research (AOFOG Journal), Bangladesh Institute of Cancer Research, Indian College of Obstetricians and Gynaecologists, Sir HN Hospital, Sai
2. Nagpada Police Hospital, Mumbai, FOGSI-2009; Nagpada Police Hospital Mumbai; Cytology Clinic, Cama and Albless Hospital, Mumbai; Wellspring Jankharia Imaging, Mumbai; St Elizabeth Hospital, Mumbai, India, GMC, Mumbai, Maharahstra, Postgraduate Institute of Medical, Science and Research, Mahatama Gandhi Memorial, Hospital Parel, Mumbai, Maharashtra, India, GMC, Mumbai, Grant Medical College and Cama and Albless Hospital, Mumbai, Mumbai, FOGSI; FOGSI (2009); N Wadia Hospital, Mumbai; ESIC-PGIMSR, MGMH, Mumbai; GMC Mumbai, Maharashtra, India; Study on Female Breast Committee FOGSI 2010-2013, N Wadia Hospital, Mumbai; ESIC-PGIMSR, MGMH, Mumbai; Government Medical College, Mumbai, Maharashtra, India; FOGSI; FOGSI-2009; Journal OBGYN of India
3. Cama and Albless Hospital, Mumbai, India, Varsha Parekh Maternity and Surgical Hospital Chembur, Gynecologist in Central Health Home, Bhandup, Mumbai, India
Chapter keywords

Abstract

Worldwide, cervical cancer is the second most common cancer among women with an estimated 493,000 new cases occurring annually and 274,000 deaths occurring each year. Well organized and well implemented cytology based screening programs have drastically reduced the incidence and mortality in the developed countries. Along with the use of colposcope, the shift was noted from invasive to preclinical to microinvasive disease. Due to limited financial, infrastructural and trained personnel, the incidence of cervical cancer has remained high. In India, 132,000 new cases are reported annually with 74,000 deaths occurring each year. In low resource setting, alternative methods for the cervical cancer screening since last decade are being explored. Some of these methods are: (1) Visual Inspection of Cervix, VIA, VILI, and (2) Use of Magnascope instead of Colposcopy, (3) Single visit approach, (4) Treatment with Cryosurgery for VIA +ve women, (5) Education and counseling, (6) Increasing coverage by camp approach, (7) Low cost HPV tests, and (8) HPV vaccines. IARC studies in India and Africa proved that VIA performed by trained paramedics has sensitivity of 64 to 90% and specificity of 73 to 91% which is comparable to conventional cytology Magnascope is a low cost instrument. In a single visit approach, cryosurgery to VIA+ cases is offered. The option for primary prevention using HPV vaccine and secondary prevention using highly sensitive, low cost HPV-DNA test may significantly reduce the burden of cervical cancer in low resource setting.

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