Armed with vinegar and cryotherapy: battling cervical cancer in Tanzania
AAPA ePoster library. Seliski N. 05/17/17; 180532; 189
Natasha Seliski
Natasha Seliski
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Abstract
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Purpose: Cervical cancer is responsible for the highest cancer related mortality in Tanzania. The World Health Organization recommends the 'See and Treat' method to screen for cervical cancer and treat precancerous lesions in low-resource settings where cytology and HPV testing are unavailable. It entails a cervical exam followed by the administration of acetic acid, which turns dysplastic cervical cells white (visualization with acetic acid or VIA), and then offering cryotherapy treatment to those with positive VIA. The purpose of this project was to screen women for cervical cancer in Tanzania, treat precancerous lesions and train local health care providers in the 'See and Treat' method in order to start local screening programs. Methodology: A 5-day 'See and Treat' healthcare worker training and cervical cancer-screening event was conducted at a hospital in Mwanza, Tanzania. Two PA students and a PA Professor participated in the course and performed cross-sectional data collection during the process. Information collected included number of women screened, demographics, self-reported HIV status, VIA status, number of women treated with cryotherapy and number of women referred for cervical lesions concerning for cancer. In addition, Tanzanian healthcare workers were trained in performing screening and cryotherapy, when indicated. Results: A total of 544 women were screened for cervical cancer and 10 Tanzanian healthcare workers were trained in the 'See and Treat' method in the 5-day event. The median age of women screened was 34 years (IQR 28-41), 7(1%) women did not report age. Six women (1%) presented with lesions suspicious for cervical cancer prior to administration of acetic acid, and were therefore referred directly for management. Interestingly, of these women, 5 (83%) were ≥ to the age of 40 (p=0.01 when compared to cases suspicious for cancer < 40 years of age). Fifty-one (9%) of all women screened were VIA positive. Women in the age groups 20-29 and 30-39 accounted for 82% of VIA positive patients (p< 0.05) and therefore had the greatest benefit of screening. A total of 42 women (95% of those VIA positive) were treated with cryotherapy. Twenty-two (4%) women self-reported to be HIV positive and 5 (22%) HIV positive women were also VIA positive. HIV positive patients had a higher VIA positive rate than HIV negative patients (p=0.07), however these results are limited by the small sample size of patients who reported to be HIV positive. ...
Purpose: Cervical cancer is responsible for the highest cancer related mortality in Tanzania. The World Health Organization recommends the 'See and Treat' method to screen for cervical cancer and treat precancerous lesions in low-resource settings where cytology and HPV testing are unavailable. It entails a cervical exam followed by the administration of acetic acid, which turns dysplastic cervical cells white (visualization with acetic acid or VIA), and then offering cryotherapy treatment to those with positive VIA. The purpose of this project was to screen women for cervical cancer in Tanzania, treat precancerous lesions and train local health care providers in the 'See and Treat' method in order to start local screening programs. Methodology: A 5-day 'See and Treat' healthcare worker training and cervical cancer-screening event was conducted at a hospital in Mwanza, Tanzania. Two PA students and a PA Professor participated in the course and performed cross-sectional data collection during the process. Information collected included number of women screened, demographics, self-reported HIV status, VIA status, number of women treated with cryotherapy and number of women referred for cervical lesions concerning for cancer. In addition, Tanzanian healthcare workers were trained in performing screening and cryotherapy, when indicated. Results: A total of 544 women were screened for cervical cancer and 10 Tanzanian healthcare workers were trained in the 'See and Treat' method in the 5-day event. The median age of women screened was 34 years (IQR 28-41), 7(1%) women did not report age. Six women (1%) presented with lesions suspicious for cervical cancer prior to administration of acetic acid, and were therefore referred directly for management. Interestingly, of these women, 5 (83%) were ≥ to the age of 40 (p=0.01 when compared to cases suspicious for cancer < 40 years of age). Fifty-one (9%) of all women screened were VIA positive. Women in the age groups 20-29 and 30-39 accounted for 82% of VIA positive patients (p< 0.05) and therefore had the greatest benefit of screening. A total of 42 women (95% of those VIA positive) were treated with cryotherapy. Twenty-two (4%) women self-reported to be HIV positive and 5 (22%) HIV positive women were also VIA positive. HIV positive patients had a higher VIA positive rate than HIV negative patients (p=0.07), however these results are limited by the small sample size of patients who reported to be HIV positive. ...
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