Screen, Notify, See, and Treat: Initial Results of Cervical Cancer Screening and Treatment in Rwanda.

Autor:	Muhimpundu MA; Rwanda Biomedical Center, Kigali, Rwanda., Ngabo F; Rwanda Biomedical Center, Kigali, Rwanda., Sayinzoga F; Rwanda Biomedical Center, Kigali, Rwanda., Balinda JP; Rwanda Biomedical Center, Kigali, Rwanda., Rusine J; National Reference Laboratory, Kigali, Rwanda., Harward S; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH., Eagan A; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH., Krivacsy S; University of Global Health Equity, Kigali, Rwanda., Bayingana A; University of Global Health Equity, Kigali, Rwanda., Uwimbabazi JC; National Reference Laboratory, Kigali, Rwanda.; Clinical Microbiology Laboratory, CHU de Liège, University of Liege, Liege, Belgium., Makuza JD; Rwanda Biomedical Center, Kigali, Rwanda., Ngirabega JD; Rwanda Biomedical Center, Kigali, Rwanda., Binagwaho A; University of Global Health Equity, Kigali, Rwanda.; Harvard Medical School, Boston, MA.; Geisel School of Medicine, Dartmouth College, Hanover, NH.
Jazyk:	angličtina
Zdroj:	JCO global oncology [JCO Glob Oncol] 2021 Apr; Vol. 7, pp. 632-638.
DOI:	10.1200/GO.20.00147
Abstrakt:	Purpose: To describe the first year results of Rwanda's Screen, Notify, See, and Treat cervical cancer screening program, including challenges encountered and revisions made to improve service delivery. Methods: Through public radio broadcasts, meetings of local leaders, church networks, and local women's groups, public awareness of cervical cancer screening opportunities was increased and community health workers were enlisted to recruit and inform eligible women of the locations and dates on which services would be available. Screening was performed using human papillomavirus (HPV) DNA testing technology, followed by visual inspection with acetic acid (VIA), and cryotherapy, biopsy, and surgical treatment for those who tested HPV-positive. These services were provided by five district hospitals and 15 health centers to HIV-negative women of age 35-45 and HIV-positive women of age 30-50. Service utilization data were collected from the program's initiation in September 2013 to October 2014. Results: Of 7,520 cervical samples tested, 874 (11.6%) screened HPV-positive, leading 780 (89%) patients to undergo VIA. Cervical lesions were found in 204 patients (26.2%) during VIA; of these, 151 were treated with cryoablation and 15 were referred for biopsies. Eight patients underwent complete hysterectomy to treat advanced cervical cancer. Challenges to service delivery included recruitment of eligible patients, patient loss to follow-up, maintaining HIV status confidentiality, and efficient use of consumable resources. Conclusion: Providing cervical cancer screening services through public health facilities is a feasible and valuable component of comprehensive women's health care in resource-limited settings. Special caution is warranted in ensuring proper adherence to follow-up and maintaining patient confidentiality.
Databáze:	MEDLINE
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