Annals of Tropical Medicine and Public Health
Home About us Ahead Of Print Instructions Submission Subscribe Advertise Contact e-Alerts Editorial Board Login 
Users Online:394
  Print this page  Email this page Small font sizeDefault font sizeIncrease font size
 


 
Table of Contents   
EDITORIAL COMMENTARY  
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1121-1122
Encouraging and expanding screening activities for cervical cancer in low-resource settings


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

Click here for correspondence address and email

Date of Web Publication6-Nov-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Encouraging and expanding screening activities for cervical cancer in low-resource settings. Ann Trop Med Public Health 2017;10:1121-2

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Encouraging and expanding screening activities for cervical cancer in low-resource settings. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Dec 6];10:1121-2. Available from: http://www.atmph.org/text.asp?2017/10/5/1121/217540


Dear Editor,

Globally, cervical cancer remains one of the commonest cancers among women and is a major cause of public health concern among women with poor socioeconomic status.[1] In fact, the current global estimates suggest that 0.53 million cases were reported in 2012 and that provision of treatment at an early stage can prevent the development of malignancy in almost four-fifth of the cases among developed nations.[1] Further, it has been reported that more than 85% of the malignancy-attributed deaths have been reported in developing nations, which is a cause of grave concern for the health authorities, as they have failed badly in extending or expanding routine screening activities.[1]

The available evidence suggests that 13 different types of human papilloma virus (HPV) can result in the development of malignancy.[1],[2]

Moreover, potential factors like early first sexual intercourse, multiple sexual partners, poor genital hygiene, poor financial status, and immune suppression often fast-track the process of progression of the disease and development of malignancy.[1],[2] The developed nations have succeeded in reducing the incidence of malignancy or associated complications/mortality because of the better organization of the screening activities, which enables identification of the premalignant growths.[1],[2] However, developing nations are still struggling to improve the access of people to effective screening services; thus, the condition is diagnosed more often than not in the advanced stages, which then have poor prognosis.[2],[3]

Screening for the malignancy has been advocated for every woman within the age group of 30–49 years at least once in a lifetime, and ideally more frequently, to enable detection of precancerous lesions (which can be easily treated and the risk of development of malignancy can be averted) or even a cancerous growth to achieve a high cure potential.[1],[3] Further, three different methods (viz.  Pap smear More Details, visual inspection with acetic acid, HPV testing) are available, and it has been estimated that more than 50% of the deaths can be minimized through effective screening and treatment initiatives.[1],[2],[4] Also, it is important to understand that the available HPV vaccines are extremely effective in preventing the acquisition of infection, but they have to be administered prior to first sexual activity.[1] In addition, the vaccine cannot act as a substitute for screening activities.[1]

The available estimates suggest that Haiti has shown quite high incidence of the malignancy, and it has been reported that 20% of all deaths reported among women in the nation are because of cervical cancer alone.[4],[5] All these alarming estimates are because of the poor screening activities or limited health infrastructure and the propensity of the disease to affect the most vulnerable groups of women.[3],[4],[5] In order to respond to the challenge, the national health ministry has joined hands with international agencies and established screening centers, which are manned by the trained nurse or midwives.[5]

These workers have been trained to perform screening through acetic acid and refer any women with a slight trace of cancerous lesion to the specialized center.[5] The best part is that the screening tool is not time-consuming, is painless, is noninvasive, is cheaper, and is life-saving tool.[1],[4] Further, women with positive cancerous lesions have been treated with cryotherapy and the instrument has been installed in many centers as a part of the expansion of malignancy-related screening and treatment activities.[5] In addition, even outreach health workers have been provided with self-sampling devices to be given to women in their routine home visits and eventually neutralize the barrier associated with healthcare establishments.[6]

To conclude, cervical cancer is affecting the lives of millions of poor women across the world and most of these adverse consequences can be averted by expansion of the screening and treatment campaign against the disease, especially in low-resource settings.

Acknowledgements

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization. Human papillomavirus (HPV) and cervical cancer-Fact sheet; 2016.Available from: http://www.who.int/ mediacentre/factsheets/fs380/en/. [Last accessed on 2016 Aug 25].   Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. Screening of cervical cancer: barriers and facilitators. Iran J Cancer Prev 2013;6:177-8.   Back to cited text no. 2
[PUBMED]    
3.
Msyamboza KP, Phiri T, Sichali W, Kwenda W, Kachale F. Cervical cancer screening uptake and challenges in Malawi from 2011 to 2015: retrospective cohort study. BMC Public Health 2016;16:806.   Back to cited text no. 3
    
4.
Roger E, Nwosu O. Diagnosing cervical dysplasia using visual inspection of the cervix with acetic acid in a woman in rural Haiti. Int J Environ Res Public Health 2014;11:12304-11.   Back to cited text no. 4
[PUBMED]    
5.
UNFPA. Haitian women felled by preventable cancer; simple test to save lives. 2016; Available from: http://www.unfpa.org/news/ haitian-women-felled-preventable-cancer-simple-test-save-lives. [Last accessed on 26 Aug 2016].   Back to cited text no. 5
    
6.
Mandigo M, Frett B, Laurent JR, Bishop I, Raymondville M, Marsh S, et al. Pairing community health workers with HPV self-sampling for cervical cancer prevention in rural Haiti. Int J Gynaecol Obstet 2015;128:206-10.  Back to cited text no. 6
[PUBMED]    

Top
Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.217540

Rights and Permissions




 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Email Alert *
    Add to My List *


    References

 Article Access Statistics
    Viewed1025    
    Printed22    
    Emailed0    
    PDF Downloaded18    
    Comments [Add]    

Recommend this journal