BC Women's Hospital and Health Center, Women's Health Research Institute, Vancouver, Canada.
University of British Columbia, Faculty of Medicine, Vancouver, Canada.
Int J Cancer. 2023 Apr 15;152(8):1630-1639. doi: 10.1002/ijc.34369. Epub 2022 Nov 28.
Cervical cancer remains a significant public health burden in low-resourced countries. Thus, the WHO prioritized cervix screening, and recently recommended thermal ablation treatment for cervical precancer. However, there is limited information on side effects during treatment and recovery, and acceptability among those treated. The ASPIRE Mayuge trial recruited women to participate in self-collection cervix screening between 2019 and 2020 (N = 2019). Screen-positive women (N = 531, 26.3%) were referred for visual inspection with acetic acid and thermal ablation treatment, per Uganda Ministry of Health recommendations; 71.2% of those referred attended follow-up. Six months post-screening, a subset of trial participants were recontacted. Those who received thermal ablation completed a survey assessing side effects during and after the procedure, and willingness to recommend the treatment to others. We summarized the results to describe the side effects and acceptability of thermal ablation treatment. Of 2019 participants, 349 (17%) received thermal ablation. A subset of 135 completed the follow-up survey, where 90% reported pain during treatment; however, intensity and duration were low. Over a third of women reported problems with recovery for reasons including pain, discharge and bleeding. Regardless, 98% reported they would recommend the treatment to others. The use of thermal ablation to treat cervical precancer appears to be highly acceptable in this population. While many women reported side effects during the procedure and recovery, the majority said they would recommend the treatment to others. However, given the substantial proportion who reported problems with recovery, efforts should be made to provide additional resources to women after receiving thermal ablation treatment for cervical precancer.
在资源匮乏的国家，宫颈癌仍然是一个重大的公共卫生负担。因此，世界卫生组织优先考虑子宫颈筛查，并最近推荐热消融治疗宫颈癌前病变。然而，关于治疗和恢复期间的副作用以及接受治疗者的可接受性，信息有限。ASPIRE 马尤盖试验于 2019 年至 2020 年期间招募妇女参与自我采集子宫颈筛查（N=2019）。根据乌干达卫生部的建议，筛查阳性的妇女（N=531，26.3%）被转诊进行醋酸视觉检查和热消融治疗；转诊的妇女中有 71.2%参加了随访。筛查后 6 个月，试验的一部分参与者被重新联系。接受热消融治疗的妇女完成了一项调查，评估治疗过程中和治疗后的副作用以及向他人推荐治疗的意愿。我们总结了结果以描述热消融治疗的副作用和可接受性。在 2019 名参与者中，有 349 名（17%）接受了热消融治疗。其中 135 名完成了随访调查，90%的人报告在治疗过程中有疼痛；然而，疼痛的强度和持续时间较低。超过三分之一的妇女因疼痛、分泌物和出血等原因报告恢复困难。尽管如此，98%的人表示会向他人推荐这种治疗方法。在该人群中，使用热消融治疗宫颈癌前病变似乎非常受欢迎。虽然许多妇女在治疗过程中和恢复期间报告了副作用，但大多数人表示会向他人推荐这种治疗方法。然而，鉴于报告恢复问题的妇女比例相当大，应该努力为接受宫颈癌前病变热消融治疗的妇女提供额外的资源。
