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https://www.readbyqxmd.com/read/28902073/cryotherapy-reduces-progression-of-cervical-intraepithelial-neoplasia-grade-1-in-south-african-hiv-infected-women-a-randomized-controlled-trial
#1
Cynthia Firnhaber, Avril Swarts, Bridgette Goeieman, Ntombi Rakhombe, Masangu Mulongo, Anna-Lise Williamson, Pam Michelow, Sibongile Ramotshela, Mark Faesen, Simon Levin, Timothy Wilkin
BACKGROUND: HIV-infected women are at increased risk of cervical cancer, especially in resource-limited countries. Cervical cancer prevention strategies focus treating cervical high-grade squamous intraepithelial lesions (HSIL). The management of low-grade squamous intraepithelial lesions (LSIL) in HIV-infected women is unknown. SETTING: HIV treatment clinic in Johannesburg, South Africa METHODS:: We randomized HIV-infected women with histologic cervical LSIL to cervical cryotherapy vs...
September 7, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28861459/development-of-a-comprehensive-and-sustainable-gynecologic-oncology-training-program-in-western-kenya-a-low-resource-setting
#2
Barry Rosen, Peter Itsura, Philip Tonui, Alan Covens, Luc van Lonkhuijzen, Elkanah Omenge Orang'o
To provide information on the development of a gynecologic oncology training program in a low-resource setting in Kenya. This is a review of a collaboration between Kenyan and North American physicians who worked together to develop a gynecologic oncology training in Kenya. We review the published data on the increase of cancer incidence in sub-Saharan Africa and outline the steps that were taken to develop this program. The incidence of cervical cancer in Kenya is very high and is the leading cause of cancer mortality in Kenya...
August 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28790867/cervical-cancer-screening-in-low-resource-settings-a-smartphone-image-application-as-an-alternative-to-colposcopy
#3
Caroline Gallay, Anne Girardet, Manuela Viviano, Rosa Catarino, Anne-Caroline Benski, Phuong Lien Tran, Christophe Ecabert, Jean-Philippe Thiran, Pierre Vassilakos, Patrick Petignat
BACKGROUND: Visual inspection after application of acetic acid (VIA) and Lugol's iodine (VILI) is a cervical cancer (CC) screening approach that has recently been adopted in low- and middle-income countries (LMIC). Innovative technologies allow the acquisition of consecutive cervical images of VIA and VILI using a smartphone application. The aim of this study was to evaluate the quality of smartphone images in order to assess the feasibility and usability of a mobile application for CC screening in LMIC...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28763729/an-evaluation-of-clinical-performance-of-fta-cards-for-hpv-16-18-detection-using-cobas-4800-hpv-test-compared-to-dry-swab-and-liquid-medium
#4
Li Dong, Chunqing Lin, Li Li, Margaret Wang, Jianfeng Cui, Ruimei Feng, Bin Liu, Zeni Wu, Jia Lian, Guangdong Liao, Wen Chen, Youlin Qiao
BACKGROUNDS: Effective dry storage and transport media as an alternative to conventional liquid-based medium would facilitate the accessibility of women in the low-resource settings to human papillomavirus (HPV)- based cervical cancer screening. OBJECTIVE: To evaluate analytical and clinical performance of indicating FTA™ Elute Cartridge (FTA card) for the detection of HPV16/18 and cervical precancerous lesions and cancer compared to dry swab and liquid medium...
June 29, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28717699/opportunistic-breast-cancer-education-and-screening-in-rural-honduras
#5
Linda S Kennedy, Suyapa A Bejarano, Tracy L Onega, Derek S Stenquist, Mary D Chamberlin
PURPOSE: In Honduras, the breast cancer burden is high, and access to women's health services is low. This project tested the connection of community-based breast cancer detection with clinical diagnosis and treatment in a tightly linked and quickly facilitated format. METHODS: The Norris Cotton Cancer Center at Dartmouth College partnered with the Honduran cancer hospital La Liga Contra el Cancer to expand a cervical cancer screening program, which included self-breast exam (SBE) education and clinical breast exams (CBEs), to assess patient attitudes about and uptake of breast cancer education and screening services...
August 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28710075/the-cost-effectiveness-of-visual-triage-of-human-papillomavirus-positive-women-in-three-low-and-middle-income-countries
#6
Nicole G Campos, Jose Jeronimo, Vivien Tsu, Philip E Castle, Mercy Mvundura, Jane J Kim
BACKGROUND: World Health guidelines support HPV testing alone (followed by treatment with cryotherapy) or in conjunction with visual inspection with acetic acid (VIA) triage testing. Our objective was to determine the cost-effectiveness of VIA triage for HPV-positive women in low-resource settings. METHODS: We calibrated mathematical simulation models of HPV infection and cervical cancer to epidemiologic data from India, Nicaragua, and Uganda. Using cost and test performance data from the START-UP demonstration projects, we assumed screening took place either once or three times in a lifetime between ages 30 and 40 years...
July 14, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28707435/evidence-based-policy-choices-for-efficient-and-equitable-cervical-cancer-screening-programs-in-low-resource-settings
#7
Nicole G Campos, Vivien Tsu, Jose Jeronimo, Mercy Mvundura, Jane J Kim
Women in developing countries disproportionately bear the burden of cervical cancer. The availability of prophylactic vaccines against human papillomavirus (HPV) types 16 and 18, which cause approximately 70% of cervical cancers, provides reason for optimism as roll-out begins with support from Gavi, the Vaccine Alliance. However, for the hundreds of millions of women beyond the target age for HPV vaccination, cervical cancer screening to detect and treat precancerous lesions remains the only form of prevention...
August 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28702405/the-impact-of-irradiation-dose-on-the-computed-tomography-radiographic-response-of-metastatic-nodes-and-clinical-outcomes-in-cervix-cancer-in-a-low-resource-setting
#8
Matthew Ryan McKeever, Lindsay Hwang, Jennifer Barclay, Yin Xi, April Bailey, Kevin Albuquerque
INTRODUCTION: The aim of this study is to investigate the relationship between the radiation dose to pelvic and para-aortic lymph nodes, nodal response, and clinical outcomes in a resource-poor setting based on computed tomography (CT) nodal size alone. MATERIALS AND METHODS: This retrospective study from 2009 to 2015 included 46 cervical cancer patients with 133 metastatic pelvic and para-aortic lymph nodes definitively treated with chemoradiation and brachytherapy in a public hospital with limited access to positron emission tomography (PET) scans...
April 2017: South Asian Journal of Cancer
https://www.readbyqxmd.com/read/28691336/management-algorithms-for-cervical-cancer-screening-and-precancer-treatment-for-resource-limited-settings
#9
Partha Basu, Filip Meheus, Youssef Chami, Roopa Hariprasad, Fanghui Zhao, Rengaswamy Sankaranarayanan
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). While VIA-positive women can be offered immediate ablative treatment based on certain eligibility criteria, HPV-positive women need to undergo subsequent VIA to determine their eligibility...
July 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28691333/treatment-of-cervical-intraepithelial-lesions
#10
Philip E Castle, Dan Murokora, Carlos Perez, Manuel Alvarez, Swee Chong Quek, Christine Campbell
Precancerous cervical lesions precede the development of invasive cervical cancer by 10-20 years, making cervical cancer preventable if these lesions are detected and effectively treated. Treatment has evolved in the last few decades and now includes ablative options that can be performed in lower-resource settings where surgical excision is not feasible or routinely available. Gas-based cryotherapy, which freezes cervical tissue to induce localized necrosis, is the most commonly used ablative treatment. However, its implementation in low-resource settings is difficult because the refrigerant gas can be difficult to procure and transport, and is expensive...
July 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28691332/advocacy-communication-and-partnerships-mobilizing-for-effective-widespread-cervical-cancer-prevention
#11
Scott Wittet, Jenny Aylward, Sally Cowal, Jacqui Drope, Etienne Franca, Sarah Goltz, Taona Kuo, Heidi Larson, Silvana Luciani, Emmanuel Mugisha, Celina Schocken, Julie Torode
Both human papillomavirus (HPV) vaccination and screening/treatment are relatively simple and inexpensive to implement at all resource levels, and cervical cancer screening has been acknowledged as a "best buy" by the WHO. However, coverage with these interventions is low where they are needed most. Failure to launch or expand cervical cancer prevention programs is by and large due to the absence of dedicated funding, along with a lack of recognition of the urgent need to update policies that can hinder access to services...
July 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28691330/cervical-cancer-data-and-data-systems-in-limited-resource-settings-challenges-and-opportunities
#12
Jennifer L Drummond, Martin C Were, Silvina Arrossi, Kara Wools-Kaloustian
Appropriate collection and use of health information is critical to the planning, scaling up, and improvement of cervical cancer programs. The health information systems implementation landscape is unique to each country; however, systems serving cervical cancer programs in low-resource settings share characteristics that present common challenges. In response, many programs have taken innovative approaches to generating the quality information needed for decision making. Recent advances in health information technology also provide feasible solutions to challenges...
July 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28691328/the-investment-case-for-cervical-cancer-elimination
#13
Vivien Davis Tsu, Ophira Ginsburg
We already know what causes cervical cancer, how to prevent it, and how to treat it, even in resource-constrained settings. Inequitable access to human papillomavirus vaccine for girls and screening and precancer treatment for women in low- and middle-income countries is unacceptable on ethical, social, and financial grounds. The burden of cervical cancer falls on the poor and extends beyond the narrow bounds of the family, affecting national economic development and community life, as family resources are drained and poverty tightens its grip...
July 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28680281/choosing-wisely-in-cancer-control-across-canada-a-set-of-baseline-indicators
#14
K Tran, R Rahal, S Fung, G Lockwood, C Louzado, J Xu, H Bryant
Value-based care, which balances high-quality care with the most efficient use of resources, has been considered the next frontier in cancer care and a means to maintain health system sustainability. Created to promote value-based care, Choosing Wisely Canada-modelled after Choosing Wisely in the United States-is a national clinician-driven campaign to identify unnecessary or harmful services that are frequently used in Canada. As part of the campaign, national medical societies have developed recommendations for tests and treatments that clinicians and patients should question...
June 2017: Current Oncology
https://www.readbyqxmd.com/read/28669152/cervical-cancer-screening-in-resource-constrained-countries-current-status-and-future-directions
#15
REVIEW
Ruchika Gupta, Sanjay Gupta, Ravi Mehrotra, Pushpa Sodhani
Cervical cancer continues to be a major public health problem affecting large numbers of women in many developing countries. Limitations of various screening modalities and the lack of ready availability of a cost-effective point-of-care screening tool have hindered the efficient implementation of population-based screening programs in these settings. It has not proved possible for many countries to adopt cytology as a screening modality due to inadequate infrastructure and trained manpower. However, recent developments, notably design and testing of a low-cost HPV test kit and initiatives by countries like India in developing and putting into operation a framework for large-scale screening of women, have raised hopes that cervical cancer control may be possible even in resource-constrained locations...
June 25, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28662160/previous-cervical-cytology-and-high-risk-human-papillomavirus-testing-in-a-cohort-of-patients-with-invasive-cervical-carcinoma-in-shandong-province-china
#16
Liran Zhang, Fengxiang Xie, Xinguo Wang, Dezhi Peng, Chunrui Bi, Lingbo Jiang, Dongman Zhao, Xinxin Tian, Debo Qi
BACKGROUND: Currently, available data regarding previous cervical cytology and high-risk human papillomavirus (hrHPV) test results to detect invasive cervical cancer are limited and controversial in China. Therefore, this retrospective study in a population of Chinese women with invasive cervical carcinoma aimed to gain further insight into the roles of cytology and hrHPV testing in cervical cancer screening. METHODS: A total of 1214 cases with a histological diagnosis of invasive cervical cancer were retrieved from the Pathology Database of Jinan KingMed Diagnostics (JKD) over a 5-year period...
2017: PloS One
https://www.readbyqxmd.com/read/28580596/cervical-cancer-screening-in-a-low-resource-setting-a-pilot-study-on-an-hpv-based-screen-and-treat-approach
#17
Margot Kunckler, Fanny Schumacher, Bruno Kenfack, Rosa Catarino, Manuela Viviano, Eveline Tincho, Pierre-Marie Tebeu, Liliane Temogne, Pierre Vassilakos, Patrick Petignat
Cervical cancer (CC) is the leading cause of cancer-related death among women in sub-Saharan Africa, primarily because of limited access to effective screening and preventive treatment. Our aim was to assess the feasibility of a human papillomavirus (HPV)-based CC screen-and-treat approach in a low-resource context. We recruited 1012 women aged 30-49 years through a CC screening campaign conducted in the District Hospital of Dschang, Cameroon. Participants performed HPV self-sampling, which was tested for high-risk HPV (HR-HPV) DNA using the point-of-care Xpert HPV assay...
July 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28369405/cost-effectiveness-of-an-hpv-self-collection-campaign-in-uganda-comparing-models-for-delivery-of-cervical-cancer-screening-in-a-low-income-setting
#18
Nicole G Campos, Vivien Tsu, Jose Jeronimo, Denise Njama-Meya, Mercy Mvundura, Jane J Kim
With the availability of a low-cost HPV DNA test that can be administered by either a healthcare provider or a woman herself, programme planners require information on the costs and cost-effectiveness of implementing cervical cancer screening programmes in low-resource settings under different models of healthcare delivery. Using data from the START-UP demonstration project and a micro-costing approach, we estimated the health and economic impact of once-in-a-lifetime HPV self-collection campaign relative to clinic-based provider-collection of HPV specimens in Uganda...
September 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28357043/recent-advances-in-understanding-and-preventing-human-papillomavirus-related-disease
#19
REVIEW
Karin Hellner, Lucy Dorrell
High-risk human papillomaviruses (hrHPV) are responsible for anogenital and oropharyngeal cancers, which together account for at least 5% of cancers worldwide. Industrialised nations have benefitted from highly effective screening for the prevention of cervical cancer in recent decades, yet this vital intervention remains inaccessible to millions of women in low- and middle-income countries (LMICs), who bear the greatest burden of HPV disease. While there is an urgent need to increase investment in basic health infrastructure and rollout of prophylactic vaccination, there are now unprecedented opportunities to exploit recent scientific and technological advances in screening and treatment of pre-invasive hrHPV lesions and to adapt them for delivery at scale in resource-limited settings...
2017: F1000Research
https://www.readbyqxmd.com/read/28351879/a-non-gas-based-cryotherapy-system-for-the-treatment-of-cervical-intraepithelial-neoplasia-a-mixed-methods-approach-for-initial-development-and-testing
#20
Miriam Cremer, Proma Paul, Katie Bergman, Michael Haas, Mauricio Maza, Albert Zevallos, Miguel Ossandon, Jillian D Garai, Jennifer L Winkler
BACKGROUND: Gas-based cryotherapy is the most widely used treatment strategy for cervical intraepithelial neoplasia (CIN) in low-resource settings, but reliance on gas presents challenges in low- and middle-income countries (LMICs). Our team adapted the original CryoPen Cryosurgical System, a cryotherapy device that does not require compressed gas and is powered by electricity, for use in LMICs. METHODS: A mixed-methods approach was used involving both qualitative and quantitative methods...
March 24, 2017: Global Health, Science and Practice
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