Cervical cancer: evolving prevention strategies for developing countries.
Cervical cancer is a leading cause of morbidity and mortality among women in many regions across the globe, although 80% of new cases of cervical cancer worldwide occur among women in developing countries. This form of cancer is highly preventable, especially with the advent of new, low-cost screening and treatment methods. Scarce resources, limited infrastructure, and competing health priorities, however, have prevented most developing country health systems from implementing successful cervical cancer prevention and control programs. Existing resources have typically been allocated to high-cost treatment for late-stage disease, which rarely saves women's lives. This paper argues that alternate approaches may help make prevention programs more viable where resources are limited. Public health approaches for preventing cervical cancer are essential to reducing mortality. The authors discuss the natural history of cervical cancer, prevention and control, screening practices, treatment practices, women's and providers' perspectives, the policy implications of alternative screening and treatment approaches, visual screening, and developing a plan of action.