Development*of*a*Cervical*Cancer*Screening* - - PowerPoint PPT Presentation

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Development*of*a*Cervical*Cancer*Screening* - - PowerPoint PPT Presentation

Feb 07, 2023 105 likes •153 views

Development*of*a*Cervical*Cancer*Screening* and*Treatment*Program*in*Western*Kenya* Cervical*cancer*is*1*cause*of*cancer*death*for*women*in*Kenya* Screening*is*difficult*for*mul?ple*reasons:*economic,*cultural,*

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Development*of*a*Cervical*Cancer*Screening* and*Treatment*Program*in*Western*Kenya*

  • Cervical*cancer*is*1*cause*of*cancer*death*for*women*in*Kenya*
  • Screening*is*difficult*for*mul?ple*reasons:*economic,*cultural,*

technical,*organiza?onal.*

  • In*2009*a*pilot*study*of*150*conducted*comparing*HPV/VIA*and*

colposcopy*

  • Permanent*clinic*established*with*subsequent*expansion*to*6*

different*sites*in*just*3*years*

  • SeeTandTtreat*strategy*implemented*with*VIA*plus*cryotherapy/LEEP*
  • Support*for*screening*included*development*of*a*gyn*oncology*

program*which*included*radical*pelvic*surgery,*chemotherapy,*and* when*possible*radia?on*

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Data*

Screened' 14,293' Number*of*centres* Colposcopy* *6* 1350* Cryotherapy* 579* LEEP* 239* Radical*Hyst* *58* CIN*1* 102* CIN2/3* 275* Microinvasive* 23* Invasive* 87*

  • Median*?me*b/w*VIA+*(cryo*ineligible)*and*

colposcopic*biopsy* * * *17*days*

  • Lost*to*followTup*b/w*VIA+and*colposcopic*

biopsy* * * * * *28%*

  • Median*?me*b/w*colposcopic*biopsy*and*

LEEP*(CIN*2/3*only) * * * *49days*

  • Lost*to*followTup*b/w*colposcopic*biopsy*and*

LEEP*(CIN*2/3*only) * * * *49%*

  • Median*?me*b/w*colposcopic*biopsy*and*

treatment*for*cancer * * *52*days*

  • Lost*to*followTup*b/w*colposcopic*biopsy*

colpo/PB*and*hyst/chemo/rads*(CIS,* MicroICC,*ICC) * * * *59%* * **

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Conclusions*

  • Successes*

– Program*has*increased*capacity*in*a*short*period*of*?me* – Program*integrated*with*a*gynecologic*oncology*program*which*manages* invasive*cases*detected*through*screening*

  • Challenges*

– Burden*of*disease*is*much*worse*than*expected,*number*of*posi?ve*screens* and*incidence*of*cancer* – Lost*to*follow*up*remains*a*significant*obstacle* – Physician*Human*Resource*limits*expansion* – Acquiring*permanent*funding*and*improving*sustainability*

  • Future**

– Maintain*capacity* – Match*mobile*colposcopy*and*mobile*LEEP**to*need*in*regional*clinics* – Decrease*LTFU*using*phone*reminders*or*transport*subsidies* – Consider*integra?ng*cervical*and*breast*screening*at*same*visit*