A handbook for leaders and managers
Cervical cancer, along with maternal deaths, has been identified as a national priority in
South Africa as well as other Sub-Saharan African countries. Cervical cancer is the
second most common
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cancer among women in South Africa, after breast cancer. Due
to limited access to prevention, early diagnosis and treatment, cervical cancer is often
fatal.
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This publication gives a broad vision of what a comprehensive approach to cervical cancer prevention and control means. In particular, it outlines the complementary strategies for comprehensive cerv
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ical cancer prevention and control, and highlights the neners. This new guide updates the 2006 edition and includes the recent promising deve
ed for collaboration across programmes, organizations and partl-
opments in technologies and strategies that can address the gaps between the needs for and availability of services for cervical cancer prevention and control.
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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 and advocate about
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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
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This Plan envisions a future with the elimination of cervical cancer as a public health problem as a result of universal access to sexual health and STI prevention services, HPV vaccines, effective
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screening and precancer treatment services, treatment of invasive cervical cancer, and palliative care. It foresees that all women and girls, regardless of age, race, ethnicity, socioeconomic status, HIV status, or disability will have timely access to quality cervical cancer prevention, care, and treatment so that they can live in good health throughout the life course and enjoy the health-related human rights.
The goal is to accelerate progress toward the elimination of cervical cancer as a public health problem in the Americas by reducing incidence and mortality rates by one-third by 2030.
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This volume presents the complex patterns of cancer incidence and death around the world and evidence on effective and cost-effective ways to control cancers. The Disease Control Priorities Volume 3 evaluation of
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cancer will indicate where cancer treatment is ineffective and wasteful, and offer alternative cancer care packages that are cost-effective and suited to low-resource settings.
Disease Control Priorities, Third Edition: Volume 3
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Globally, the cancer burden is rising, exerting significant strain on
populations and health systems at all levels of income. There are
concerted efforts towards enhancing access to comprehensive
cancer
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prevention and control initiatives.
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This guidance is intended to be used by programme managers following the decision to introduce human papillomavirus (HPV) virological testing as a screening assay in their national cervical cancer preventi
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on and control programme. The guidance includes a step-by-step process to be followed after the decision has been made to specifically introduce and/or scale-up HPV virological testing for screening, which would be followed up with adequate management within the context of cervical cancer prevention
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This summary covers the preventive approach to breast cancer control and includes prophylactic medications, prophylactic surgery and lifestyle modifications for breast cancer
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prevention. Health professional training and individual risk assessments and counseling are also discussed.
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Le cancer du col de l’utérus et le cancer du sein constituent de véritables problèmes de santé publique en raison de leur fréquence. A titre d'exemple, environ 275 000 femmes meurent chaque a
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nnée d’un cancer du col de l’utérus dans le monde et la plupart de ces décès surviennent dans des pays à revenu faible (90%) car le diagnostic est souvent fait à des stades avancés de la maladie.
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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
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pes of cancer: breast, cervical, colorectal, leukemia, lung and prostate. The first section defines the global increase in cancer cases, the global goals to manage NCDs and the WHO activities related to these goals. The second section presents the methodology used for the selection of medical devices that support clinical interventions required to screen, diagnose, treat and monitor cancer stages, as well as the provision of palliative care, based on evidence-based information. The third section lists the priority medical devices required to manage cancer in seven different units of health care services: 1. Vaccination, clinical assessment and endoscopy, 2. Medical imaging and nuclear medicine, 3. Surgery, 4. Laboratory and pathology, 5. Radiotherapy, 6. Systemic therapy and 7. Palliative and end of life care
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Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that may exist at any one of three stages: CIN1, CIN2, or CIN3. If left untreated, CIN2 or CIN3 (collectively referred to as CIN2+) can progress to cervical cancer. Instead of screeni
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ng and diagnosis by the standard sequence of cytology, colposcopy, biopsy, and histological confirmation of CIN, an alternative method is to use a ‘screen-and-treat’ approach in which the treatment decision is based on a screening test and treatment is provided soon or, ideally, immediately after a positive screening test. This guideline provides recommendations for strategies for a screen-and-treat programme
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2nd edition, July 2021. This WHO and HRP guideline is designed to help countries make faster progress, more equitably, on the screening and treatment of cervical cancer. It includes some important shifts in WHO’s recommended approaches to cervical
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screening, and includes a total of 23 recommendations and 7 good practice statements.
Among the 23 recommendations, 6 are identical for both the general population of women and for women living with HIV and 12 are different and specific for each population.
Among the 7 good practice statements, 3 are identical for both the general population of women and for women living with HIV and 2 are different and specific for each population
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are mor
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e 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.
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Pan African Medical Journal 2017;27:215. doi: 10.11604/pamj.2017.27.215.12994
Globally, 311,000 women die of cervical cancer every year, 85 percent of them
in resource limited regions of the world. To address this grave threat to women,
the WHO made a call to action in 2018, resulting in accelerated plans to improve
cervic
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al cancer control under the elimination threshold with respect to cervical
cancer incidence. As part of WHO’s approach to cervical cancer control, availability of high quality,
affordable medical devices for HPV screening, and treatment of precancerous
lesions in low resource settings is indispensable.
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This WHO Guidance Note advocates for a comprehensive approach to cervical cancer prevention and control and is aimed at senior policy makers and programme managers. It describes the need to deliver
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effective interventions across the female life course from childhood through to adulthood. These include community education, social mobilization, HPV vaccination, screening, treatment and palliative care. It outlines the complementary strategies for comprehensive cervical cancer prevention and control, and highlights collaboration across national health programmes (particularly immunization, reproductive health, cancer control and adolescent health), organizations and partners.
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