采用醋酸视觉检查和冷冻疗法进行宫颈癌预防的筛查-治疗方法:秘鲁、乌干达和越南示范项目的经验、看法和信念。
Screen-and-treat approach to cervical cancer prevention using visual inspection with acetic acid and cryotherapy: experiences, perceptions, and beliefs from demonstration projects in Peru, Uganda, and Vietnam.
机构信息
PATH, Seattle, Washington, USA;
出版信息
Oncologist. 2013;18 Suppl:6-12. doi: 10.1634/theoncologist.18-S2-6.
Cervical cancer is preventable but continues to cause the deaths of more than 270,000 women worldwide each year, most of them in developing countries where programs to detect and treat precancerous lesions are not affordable or available. Studies have demonstrated that screening by visual inspection of the cervix using acetic acid (VIA) is a simple, affordable, and sensitive test that can identify precancerous changes of the cervix so that treatment such as cryotherapy can be provided. Government partners implemented screening and treatment using VIA and cryotherapy at demonstration sites in Peru, Uganda, and Vietnam. Evaluations were conducted in the three countries to explore the barriers and facilitating factors for the use of services and for incorporation of screen-and-treat programs using VIA and cryotherapy into routine services. Results showed that use of VIA and cryotherapy in these settings is a feasible approach to providing cervical cancer prevention services. Activities that can help ensure successful programs include mobilizing and educating communities, organizing services to meet women's schedules and needs, and strengthening systems to track clients for follow-up. Sustainability also depends on having an adequate number of trained providers and reducing staff turnover. Although some challenges were found across all sites, others varied from country to country, suggesting that careful assessments before beginning new secondary prevention programs will optimize the probability of success.
宫颈癌虽然可预防,但每年仍导致全球 27 万多名妇女死亡,其中大多数生活在发展中国家,这些国家没有能力负担或提供用于检测和治疗癌前病变的项目。研究表明,使用醋酸(VIA)对宫颈进行目视检查筛查是一种简单、经济实惠且敏感的检测方法,可以识别宫颈的癌前病变,从而可以提供冷冻疗法等治疗。政府合作伙伴在秘鲁、乌干达和越南的示范点实施了 VIA 和冷冻疗法筛查和治疗。在这三个国家进行了评估,以探讨使用服务的障碍和促进因素,以及将 VIA 和冷冻疗法筛查和治疗方案纳入常规服务的情况。结果表明,在这些环境中使用 VIA 和冷冻疗法是提供宫颈癌预防服务的可行方法。有助于确保项目成功的活动包括动员和教育社区、组织服务以满足妇女的日程安排和需求,以及加强系统以跟踪客户进行随访。可持续性还取决于是否有足够数量的经过培训的服务提供者以及减少人员流动。尽管在所有地点都发现了一些挑战,但其他挑战因国家而异,这表明在开始新的二级预防项目之前进行仔细评估将最大限度地提高成功的可能性。