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Effective screening programmes for cervical cancer in low- and middle-income developing countries

Bulletin of the World Health Organization, 2001-01, Vol.79 (10), p.954-962 [Peer Reviewed Journal]

COPYRIGHT 2001 World Health Organization ;Copyright World Health Organization 2001 ;ISSN: 0042-9686 ;EISSN: 1564-0604 ;DOI: 10.1590/S0042-96862001001000009 ;PMID: 11693978 ;CODEN: BWHOA6

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Title:
Effective screening programmes for cervical cancer in low- and middle-income developing countries
Author: Sankaranarayanan, R ; Budukh, A M ; Rajkumar, R
Subjects: Adult ; Africa South of the Sahara ; Aged ; Analysis ; Cellular biology ; Central America ; Cervical cancer ; Cervix ; Cervix neoplasms/diagnosis ; Cervix neoplasms/prevention and control ; Cervix uteri/cytology ; Developing countries ; Developing Countries - economics ; Developing Countries - statistics & numerical data ; Diagnosis ; Female ; Health Care Rationing ; Health Policy & Services ; Humans ; Income - classification ; India ; Industrialized nations ; LDCs ; Mass Screening - organization & administration ; Mass Screening - standards ; Mass screening/organization and administration ; Medical screening ; Middle Aged ; Mortality ; Poverty ; Precancerous Conditions - diagnosis ; Precancerous Conditions - prevention & control ; Precancerous Conditions - therapy ; Prevalence studies (Epidemiology) ; Prevention ; Program Development ; Program Evaluation ; Public health ; South Africa ; South America ; South-East Asia ; Surveillance ; Uterine Cervical Neoplasms - diagnosis ; Uterine Cervical Neoplasms - epidemiology ; Uterine Cervical Neoplasms - prevention & control ; Vagina ; Vaginal Smears ; Vaginal smears/utilization ; Womens health
Is Part Of: Bulletin of the World Health Organization, 2001-01, Vol.79 (10), p.954-962
Description: Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes--either organized or opportunistic--have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening. This article briefly reviews the experience from existing screening and research initiatives in developing countries. Substantial costs are involved in providing the infrastructure, manpower, consumables, follow-up and surveillance for both organized and opportunistic screening programmes for cervical cancer. Owing to their limited health care resources, developing countries cannot afford the models of frequently repeated screening of women over a wide age range that are used in developed countries. Many low-income developing countries, including most in sub-Saharan Africa, have neither the resources nor the capacity for their health services to organize and sustain any kind of screening programme. Middle-income developing countries, which currently provide inefficient screening, should reorganize their programmes in the light of experiences from other countries and lessons from their past failures. Middle-income countries intending to organize a new screening programme should start first in a limited geographical area, before considering any expansion. It is also more realistic and effective to target the screening on high-risk women once or twice in their lifetime using a highly sensitive test, with an emphasis on high coverage (>80%) of the targeted population. Efforts to organize an effective screening programme in these developing countries will have to find adequate financial resources, develop the infrastructure, train the needed manpower, and elaborate surveillance mechanisms for screening, investigating, treating, and following up the targeted women. The findings from the large body of research on various screening approaches carried out in developing countries and from the available managerial guidelines should be taken into account when reorganizing existing programmes and when considering new screening initiatives.
Publisher: Switzerland: World Health Organization
Language: English;Portuguese
Identifier: ISSN: 0042-9686
EISSN: 1564-0604
DOI: 10.1590/S0042-96862001001000009
PMID: 11693978
CODEN: BWHOA6
Source: Open Access: DOAJ Directory of Open Access Journals
Open Access: PubMed Central
SciELO
Geneva Foundation Free Medical Journals at publisher websites
AUTh Library subscriptions: ProQuest Central
MEDLINE

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Effective screening programmes for cervical cancer in low- and middle-income developing countries

COPYRIGHT 2001 World Health Organization ;Copyright World Health Organization 2001 ;ISSN: 0042-9686 ;EISSN: 1564-0604 ;DOI: 10.1590/S0042-96862001001000009 ;PMID: 11693978 ;CODEN: BWHOA6

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