‘SCREEN AND TREAT’ PROGRAMME FOR CERVICAL CANCER PREVENTION IN PUNE, INDIA (ID 193)
Abstract
Introduction
The World Health Organization estimates that there will be about 154 259 new cases of cervical cancer in India by 2040. We are implementing a ‘screen and treat’ programme in Pune, India with an objective to expand access to cervical cancer screening to indigent women.
Methods
The programme was initiated in November 2016. Cervical cancer screening and ablative treatment (when indicated) were provided in our ‘mobile clinic van’ to women living in and around Pune city. The screening was provided using visual inspection of the cervix with 5% acetic acid (VIA) by trained personnel followed by immediate treatment of screen-positive women with thermocoagulation (Wisap or Liger’s thermocoagulation), if eligible. Screen positive women not eligible for ablative treatment were referred for colposcopy/biopsy/excisional treatment.
Results
A total of 10 979 women aged between 30 and 60 were screened with VIA in 281 outreach screening clinics. The overall VIA positivity was 6.8% (95% CI 6.3-7.3) and there was a declining trend from 7.6% (95% CI 6.8-8.5) in the year I, 7.1% (95% CI 6.4-7.9) in year II and 5.4% (95% CI 4.6-6.3) in year III. Of the screen-positive women, 305/697 (43.8%) received treatment with thermocoagulation. Two women diagnosed with cervical cancer (2/ 10979, 0.018 %) were referred appropriately for anti-cancer treatment. There were no serious adverse events following treatment with thermocoagulation. 14/311 (4.5%) women complained of some side effect (pain/cramps in abdomen, mild bleeding, fever, discharge, severe bleeding, menorrhagia, PID) following thermocoagulation which subsided after treatment.
Conclusions
It is feasible, acceptable and safe to implement a community based cervical cancer screening programme using the ‘screen and treat’ strategy. Ablative treatment with thermocoagulation is safe and well-tolerated.
