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Low-cost cervical cancer screening in
Zambia.
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| Article Type: | Brief article |
| Subject: |
Cervical cancer
(Prevention) Cervical cancer (Diagnosis) Cancer (Diagnosis) HIV patients (Medical examination) Papillomavirus infections (Prevention) |
| Pub Date: | 05/01/2010 |
| Publication: | Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080 |
| Issue: | Date: May, 2010 Source Volume: 18 Source Issue: 35 |
| Geographic: | Geographic Scope: Zambia Geographic Code: 6ZAMB Zambia |
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| Accession Number: | 236247771 |
| Full Text: |
Cervical cancer kills more women than any other cancer in
low-income nations, particularly affecting those with HIV. With
increasing access to antiretroviral therapy (ART), HIV-positive women
may now live long enough for human papillomavirus infections to progress
to cervical cancer. Nurse-led screen-and-treat services, co-located with
ART programmes, were set up at 15 public-sector sites in Lusaka as part
of the Cervical Cancer Prevention Programme in Zambia. Nurses evaluated
6,572 HIV-positive patients with visual inspection and digital
cervicography and 3,523 (54%) were screen positive. 2,062 (59%) of these
were offered immediate cryotherapy, of whom 1,603 (78%) underwent the
procedure. The additional 1,461 (41%) were referred for further
evaluation of whom 715 (49%) underwent histological confirmation.
Clinical and surgical staging of these revealed 235 pre-cancers, 79
early-stage cancers and 36 late-stage cancers. Using published estimates
of disease progression and cure/prevention rates and assuming all women
receive treatment, researchers estimated that the programme prevented
203 invasive cervical cancer cases--equivalent to one case for every
32.3 HIV-positive women screened. This screening costs $1 compared to
Pap smears which are $15, mainly because it is nurse-led. Other
countries such as Botswana, Cameroon and Tanzania are interested in
replicating it. Early detection can reduce morbidity and mortality from
cervical cancer but there are challenges around patient attrition, the
unknown progression of the cancer in HIV-positive women, and how women
at different clinical stages of HIV react to treatment. (1,2) (1.) Parham G, Mwanahamuntu M, Sahasrabuddhe V, et al. Effectiveness of a program to prevent cervical cancer among HIV-infected women in Zambia. Presented at the 17th Conference on Retroviruses and Opportunistic Infections (CROI), February 2010. At: (2.) Zambia: Cervical cancer screening saves lives. IRIN PlusNews, 18 February 2010. |
| Gale Copyright: | Copyright 2010 Gale, Cengage Learning. All rights reserved. |
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