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Cervical Cancer Screening in Low Resource Settings Jean Talbert MD Volunteer Medical Director with PINCC November 6, 2015 Objectives • Understand the varying risk of cervical cancer worldwide • Assess options for performing cervical cancer screening in low resource settings • Identify the unique challenges of creating a sustainable screening program I, Jean Talbert, have been asked to disclose any significant relationships with commercial entities that are either providing financial support for this program or whose products or services are mentioned during my presentation. I have no relationships to disclose. I may discuss the use of vaccines in a manner not approved by the U.S. Food and Drug Administration but in accordance with ACIP recommendations. Cervical Cancer Incidence Cervical Cancer Mortality A Case Study Leading Causes of Cancer Cervical Cancer Risk Factors in Kenya HIV rates as high as 27% 22% untreated Women disproportionately affected – 57% Early age of first intercourse 10% females before age 15 Low cervical cancer screening rates 3.2% women age 18-69 have been screened Challenges • Low level of community awareness of importance of screening • Inadequate provider skills and supplies • HPV vaccine not part of national vaccination program Barriers to Screening Competing Health Demands Economic Barriers to Screening Social Political Screening Strategies • Conventional cytology (Pap test) • Visual Inspection with Acetic Acid • HPV DNA test • Cervicography VIA: Visual Inspection of the Cervix with Acetic Acid Equipment: Speculum Vinegar Cotton balls Light PINCC Non-profit, volunteer medical service organization whose mission is to create sustainable programs that prevent cervical cancer by educating women, training medical personnel and equipping facilities in developing countries, utilizing proven, low cost, accessible technology methods PINCC’s Program • Train local medical personnel • Community outreach and education • Helping women diagnosed with cervical cancer to obtain treatment • Train the trainers • Strategize for sustainability St. Vincent’s Hospital Our Team Teaching Exam Room Sterilization Technique Teaching Trainees VIA Exam Treatment Options for Dysplasia Cryotherapy LEEP Treatment Options for Cervical Cancer Referral Radiation Chemo Surgery Palliative Care Certificates Sustainability PINCC Volunteer Donate Spread the Word
