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Cervical cancer is the second most common cancer among women worldwide and causes a sig... more
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of ... mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso were limited to temporary screening campaigns. Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity. Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy. Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions. Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system. more
Self-care interventions are evidence-based, quality drugs, devices, diagnostics and/or digital products which can be provided fully or partially outside of formal health services and can be used wit... more
One of the most important ways we feel we can help to reduce the burden of cancer in Africa is to work with African cancer advocacy organisations to help educate ... advocate about cancer in their countries. To this end in 2010 we designed with our partners, 13 posters for use in Africa giving health and lifestyle tips on how to avoid cancer and highlighting the early warning sign and symptoms of common cancers in Africa more
This publication gives a broad vision of what a comprehensive approach to cervical cancer prevention and control means. In particular, it outlines ... more
Cervical cancer continues to be a significant public health problem and a major cause of premature mortality among women, disproportionately affect... more
The single-visit approach to cervical cancer prevention (also referred to as the “See-and-Treat” approach) currently involves visual inspection... more
WHO‘s Global Strategy to Accelerate the Elimination of Cervical Cancer, launched today, outlines three key steps: vaccination, screening and trea... more
The purpose of cancer screening tests is to detect pre-cancer or early-stage cancer in asymptomatic individuals so that timely diagnosis ... early treatment can be offered, where this treatment can lead to better outcomes for some people. The aim of a cancer screening programme is either to reduce mortality and morbidity in a population by early detection and early treatment of a cancer (for example, breast screening) or to reduce the incidence of a cancer by identifying and treating its precursors (such as cervical and colorectal screening). This short guide is designed to be a quick reference that contains the important ideas about cancer screening. Readers should refer to other publications for comprehensive discussion and detailed guidance on cancer screening programmes. more

Women Cancer

Henke, A.; and S. Mauder The MEDBOX Team (2021) CC
MEDBOX Issue Brief No.17, 21 November 2021 Women's cancers have a significant impact on women's health worldwide. According to the World Health Organisation, nearly three million women are diagnosed with breast or cervical ... every year. In this Issue Brief you will find more information. more
Version-1, June 2018
This document provides 3MDG stakeholders with essential information on SRHR indicators, derived from the 3MDG Logical Framework, Data Dictionary for Health Service Indicators (2014 June, DoPH, MoHA), A Guide to Monitoring and... more

Cancer in sub-Saharan Africa

Ngwa, W.; et al. Lancet Oncology Commission (2022) C2
Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8 In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence ... mortality. Without rapid interventions, data estimates show a major increase in cancer mortality from 520 348 in 2020 to about 1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive, and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial investment is needed in developing cancer registries and cancer diagnostics for core cancer tests. more
This publication is based on the list of clinical interventions selected from clinical guidelines on prevention, screening, diagnosis, treatment, palliative care, monitoring and end of life care. This publication addresses medical devices for six ty... more
This manual guides trained health care providers through the LEEP procedure to remove precancerous cervical lesions that cannot be treated with cryotherapy in order to prevent cervical .... The Standard Operating Procedures describe the equipment, step-by-step procedure, safeguards in practice, and infection prevention guidelines surrounding LEEP and recommended follow-up schedules and procedures. LEEP can be performed in an outpatient setting under local anesthesia. The procedure can be both diagnostic and therapeutic, and replaces traditional follow-up evaluations and treatments such as cold knife conization and hysterectomy more
A lack of knowledge about the threat of vaccine-preventable diseases, risks and benefits of vaccines, mistrust of government and health workers, poor service delivery ... alternative health or religious beliefs play a role in lower uptake of some vaccines. These challenges underscore the importance of early integration and investment in a thoughtful communication plan for immunization programmes. This World Health Organization (WHO) report presents communication guidance and specific considerations for countries that plan to introduce human papillomavirus (HPV) vaccine into their national immunisation programme as part of an effort to prevent cervical cancer. more
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed ... predicted trends in services over 24 months, and to estimate the number of visits lost through December 2020. METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale. RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change. CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico. more
Prepared as an outcome of ICMR Subcommittee on Cancer Cervix | This consensus document on management of cervix cancer summarizes the modalities of treatment including the site-specific anti-... therapies, supportive and palliative care and molecular markers and research questions. It also interweaves clinical, biochemical and epidemiological studies. more
The guidelines presented in this document are designed to provide a useful resource for healthcare professionals involved in clinical case management. They were developed taking into consideration services provided at different levels within the health system ... resources available. These guidelines are intended to standardize care at both tertiary and secondary levels of service delivery across different socio economic stratifications of our society. more
This report is one of the first major products of the newly established Precision Public Health Metrics unit of the UCN cluster of the WHO Regional Office for Africa. The report presents national trends in communicable and non-communicable disease b... more