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Cervical cancer screening and management of cervical pre-cancers. Training of health staff in colposcopy, LEEP and CKC. Trainees' handbook.
New Delhi, India, WHO, Regional Office for South-East Asia, 2017. 199 p.The Trainees’ handbook is designed to train gynaecologists and non-specialist clinicians in performing colposcopy and treatment of cervical precancerous conditions so they can provide the necessary diagnostic and therapeutic services in a cervical cancer screening programme. The Trainees’ handbook contains guidelines and information intended to be used both by trainees and facilitators while participating in the structured training programme on cervical cancer screening and treatment. The Trainees’ handbook contains different modules intended to assist trainees to develop their knowledge and learn the correct steps to perform colposcopy and treatment procedures. The modules contain checklists that serve as ready reckoners to develop skills in various procedures during clinical sessions. These checklists are also intended to be used by trainees during their post-training practice. The structure and methodology of the training have been designed to impart knowledge in the most effective manner and have taken into consideration the overall training objectives, profiles of trainees and the expected learning outcomes. (Excerpt)
Cervical cancer screening and management of cervical pre-cancers. Training of health staff in colposcopy, LEEP and CKC. Facilitators' guide.
New Delhi, India, WHO, Regional Office for South-East Asia, 2017. 118 p.This manual is an instruction guide for facilitators to provide competence based training to providers of colposcopy and treatment services in a cervical cancer screening programme. The training is intended to assist gynaecologists and non-specialist clinicians to learn and improve upon their skills to perform colposcopy and to treat cervical pre-cancers by excision methods. Facilitators are required to consult both the Facilitators’ guide and the Trainees’ handbook while training participants through interactive presentations, group discussions, role plays, clinical practice sessions, etc. The Facilitators’ guide contains detailed training methodologies, structure of the individual training sessions and guidelines for assessment of trainees. The Trainees’ handbook contains different modules to assist trainees with step-by-step learning of colposcopy and treatment procedures. (Excerpt)
WORLD HEALTH STATISTICS QUARTERLY. RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1987; 40(3):267-78.The primary cause of death in women in the world is cancer. In most developing countries cancer of the cervix is the most prevalent cancer. Breast cancer has this distinction in Latin America and the developed countries of North America, Europe, Australia, and New Zealand. It is also the most prevalent cancer worldwide. The most common cancer in Japan and the Soviet Union is stomach cancer. Effective early detection programs can reduce both breast and cervical cancer mortality and also the degree and duration of treatment required. In Iceland, cervical cancer mortality declined 60% between the periods of 1959-1970 and 1975-1978. Programs consist of mammography, physician breast and self examination, and Pap smear. The sophisticated early detection equipment and techniques are expensive and largely located in urban areas, however, and not accessible to urban poor women and rural women, especially in developing countries. Tobacco smoking attributes to 80-90% of all lung cancer deaths worldwide and 30% of all cancer deaths. Passive smoking increases the risk of lung cancer to 25-35% in nonsmokers who breathe in tobacco smoke. Since smoking rates of women are skyrocketing, health specialists fear that lung cancer will replace cervical and breast cancers as the most common cancer in women worldwide in 20-30 years. Tobacco use also contributes to the high incidence of oral cancer in Southern and South Eastern Asia. For example, in India, incidence of oral cancer in women is 3-7 times higher than in developed countries with the smoking and chewing of tobacco in betel quid contributing. Techniques already exist to prevent 1/3 of all cancers. If cases can be discovered early enough and adequate treatment applied, another 1/3 of the cases can be cured. In those cases where the cancer cannot be cured, drugs can relieve 80-90% of the pain.
BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1987; 65(6):817-27.Cervical cancer ranks as the 2nd most frequent cause of cancer in women. Research demonstrates that infection with the human papilloma virus (HPV) leads to cervical cancer. The clinical HPV lesion in both sexes is the pointed wart like tumor called condyloma acuminatum. Detecting subclinical lesions varies, however, based on the genital organ and on the methods of examination. Several types of HPV infect anogenital epithelia and the resultant disease is partially determined by HPV type. In vitro methods to detect HPV do not exist, so laboratory personnel must depend on biochemical diagnostic procedures--molecular hybridization and serological procedures. HPV lesions, especially HPV- 16 and HPV-18, may turn into carcinomas depending on the activation or inactivation of some unknown genes perhaps influenced by tobacco smoking, oral contraceptives, other genital infections, or other unknown cofactors. Clinicians need to realize the potential gravity of HPV infection including the pathogenesis of lesions and its transmission through sexual contact. They must also be able to perform those diagnostic procedures that can detect HPV infection. Treatment of HPV lesions (e.g., cryosurgery, cautery, etc.) aims to either cure a repulsive, infectious, yet uncomplicated condition or prevent invasive cancer if HPV is connected with intraepithelial neoplasia. The results of the few well controlled studies of treatment of anogenital HPV- induced lesions show that 15-60% of lesions return with 3 months of treatment. Researchers must discover if humoral immunity can protect against HPV infection, and if it can, a vaccine using purified structural proteins should quickly be developed and approved.