Cervical cancer is one of the leading cancers among women in India, and there is an increased need for screening as morbidity and mortality from the malignancy can be prevented. The prevention and control of cervical cancer requires a multidisciplinary effort to not only improve awareness but also to establish primary and secondary prevention strategies. As the population in remote villages do not have ease of access to major hospitals, the training of paramedical staff may be a viable option for screening women for cervical cancer.
19 rural villages with a combined population of 21,798 of whom 4121 were women above the age of 21 who never underwent screening for cervical cancer were selected. 10 villages with a population of 2113 females were willing to partake in the training of paramedical staff to screen for cervical cancer. The results of the number of positives and false positives were recorded over a 5-year span. The other 9 villages with a female population of 1968 that opted out of training paramedical staff were also followed during the same time period. Women who tested positive on VIA were treated with thermal ablation or referred to a higher medical center.
Of the 2113 women screened for cervical cancer by paramedical staff, VIA came back positive in 19.64%. It was found that on biopsy 1.7% had high grade intraepithelial and 1.17% had low grade intraepithelial. 1.98% had cervical intraepitheial neoplasia stage 2 and above. In the 9 villages where training was not done the rates of screening were poor as only 20 women were screened.
There is an ever-growing need for cervical cancer screening in the rural areas of India, and the authors believe that screening through the usage of paramedical staff may be a good option as VIA and thermal ablation are easily done. Our results show that the overall diagnosis rates and the uptake of screening was more in villages with paramedical staff. We believe the implementation of paramedical staff who are trained in VIA and thermal ablation would ultimately lead to a reduction in the rates of cervical cancer and would better health for women in the rural areas.
The authors.
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All authors have declared no conflicts of interest.