Reference Manual - IARC Screening Group

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Treatment and FollowupSchedule a followup appointment for 1 year after the procedure, and givethe woman the name of the service center or clinic to which she shouldreturn. If possible this information should be provided in writing. Finally,the woman should be given a last opportunity to ask any questions shemight have.FollowupThe woman should return for a repeat VIA testing in 1 year. At this visit,after obtaining a history of any problems, the VIA test should be doneand any abnormalities noted. Because the SCJ may not be visible, thecervix should be carefully checked to assess how it has healed andwhether any lesion persists. Criteria for retreatment or referral at this visitare listed in Table 7-8.Table 7-8. Treatment Status and Recommended ActionVIACLASSIFICATIONVIA Test-NegativePersistentProgressedOther ReferralDESCRIPTIONSCJ visibleNo acetowhite lesionVIA test-positive a , butlesion(s) less than 75% ofsurface area of cervixVIA test-positive withlarger lesion(s) than whentreated or now coveringmore than 75% of thesurface areaPersistent lesions thatqualify for retreatmentwith cryotherapy, butpatient requests referralfor a different method oftreatmenta Acetowhite lesion present regardless of whether SCJ is visible.RECOMMENDEDACTIONRepeat VIA test in 3years (if test negativethen, every 5 years)Treat again withcryotherapyRefer to center or nearestfacility offering otherdiagnostic and treatmentoptionsCounsel again aboutadvantages anddisadvantages of alltreatment methods; referto nearest facility wheretreatment of choice isofferedREFERENCESAlliance for Cervical Cancer Prevention (ACCP). 2003. Effectiveness,Safety, and Acceptability of Cryotherapy: A Systematic LiteratureReview. Cervical Cancer Prevention Issues in Depth #1. ACCP.http://www.path.org/files/RH_cryo_white_paper.pdfAndersen ES and M Husth. 1992. Cryosurgery for cervical intraepithelialneoplasia: 10-year followup. Gynecological Oncology 45: 240–242.7-20 Cervical Cancer Prevention Guidelines for Low-Resource Settings
Treatment and FollowupBerget A, B Andreasson and JE Bock. 1991. Laser and cryosurgery forcervical intraepithelial neoplasia. Acta Obstetricia et GynecologicaScandinavica 70: 231–235.Bigrigg MA et al. 1990. Colposcopic diagnosis and treatment of cervicaldysplasia in one visit. Lancet 336: 229–231.Bishop A, J Sherris and VD Tsu (eds). 1995. Cancer DysplasiaTreatment in Developing Countries: A Situation Analysis. PATH: Seattle,Washington.Bryson SCP, P Lenehan and GM Lickrish. 1985. The treatment of gradeIII cervical intraepithelial neoplasia with cryotherapy: An 11-yearexperience. American Journal of Obstetrics and Gynecology 151: 201–206.Draeby-Kristiansen J et al. 1991. Ten years after cryosurgical treatmentof cervical intraepithelial neoplasia. American Journal of Obstetrics andGynecology 165(1): 43–45.Gordon H and I Duncan. 1991. Effective destruction of cervicalintraepithelial neoplasia (CIN) 3 at 100 degrees using the Semm coldcoagulator: 14 years’ experience. British Journal of Obstetrics &Gynecology 98: 14–20.Gunasekera PC, JH Phipps and BV Lewis. 1990. Large loop excision ofthe transformation zone (LLETZ) compared to carbon dioxide laser in thetreatment of CIN: A superior mode of treatment. British Journal ofObstetrics & Gynecology 97: 995–998.Hemmingson E, U Stendahl and S Stenson. 1981. Cryosurgical treatmentof cervical intraepithelial neoplasia with followup of five to eight years.American Journal of Obstetrics and Gynecology 139(2): 144–147.Keijser KGG et al. 1992. Diathermy loop excision in the management ofcervical intraepithelial neoplasia: Diagnosis and treatment in oneprocedure. 1992. American Journal of Obstetrics and Gynecology166(4):1281–1287.Loobuyck H and I Duncan. 1993. Destruction of CIN 1 and 2 with theSemm cold coagulator: 13 years’ experience with the see-and-treatpolicy. British Journal of Obstetrics & Gynecology 100: 465–468.Luesley DM et al. 1993. Loop diathermy excision of the cervicaltransformation zone in patients with abnormal cervical smears. BritishMedical Journal 300: 1690–1693.Cervical Cancer Prevention Guidelines for Low-Resource Settings 7-21
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Cervical Cancer PreventionGuideline
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TABLE OF CONTENTSPREFACE AND ACKNOW
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How to High-Level Disinfect Surgica
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Table C-2Figure C-1Preparing a Dilu
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PREFACE AND ACKNOWLEDGMENTSThis ref
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ONEINTRODUCTIONMAGNITUDE OF THE PRO
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IntroductionFigure 1-3. Incidence o
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Introductionprevalence areas, a sta
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Table 1-2. Reduction in Cumulative
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Introductiontheir performance was t
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Introductionlesions, or a false pos
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IntroductionCompared to other metho
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Introductionsignificantly to women
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IntroductionBelinson JL et al. 2001
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IntroductionMitchell MF et al. 1998
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IntroductionYlitalo N et al. 1999.
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TWOHUMAN PAPILLOMAVIRUS AND CERVICA
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Human Papillomavirus and Cervical C
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THREEPATHOPHYSIOLOGY OF CERVICAL CA
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With the onset of puberty, whichis
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Pathophysiology of Cervical Cancerp
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Pathophysiology of Cervical CancerP
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Pathophysiology of Cervical CancerI
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Pathophysiology of Cervical CancerR
Page 59 and 60: FOURTALKING WITH WOMEN ABOUTCERVICA
Page 61 and 62: Talking with Women About Cervical C
Page 69 and 70: FIVEPREVENTING INFECTIONS INHEALTHC
Page 71 and 72: Preventing Infections in Healthcare
Page 79 and 80: SIXCLIENT ASSESSMENT AND VIA TESTIN
Page 81 and 82: Client Assessment and VIA TestingFi
Page 83 and 84: Client Assessment and VIA TestingIN
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Page 87 and 88: Client Assessment and VIA Testingsp
Page 89 and 90: Client Assessment and VIA Testingth
Page 91 and 92: SEVENTREATMENT AND FOLLOWUPBACKGROU
Page 93 and 94: Treatment and Followupregardless of
Page 95 and 96: Treatment and FollowupFigure 7-1. L
Page 97 and 98: Treatment and FollowupTable 7-6. Co
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Page 101 and 102: Treatment and Followup• Regulator
Page 103 and 104: Treatment and FollowupCRYOTHERAPY P
Page 105 and 106: Treatment and FollowupStep 6 Point
Page 107 and 108: Treatment and FollowupNote: When CO
Page 109: Treatment and FollowupStep 5Advise
Page 113 and 114: APPENDIX ATESTS FOR CERVICAL CANCER
Page 115 and 116: Tests for Cervical Cancer Screening
Page 121 and 122: APPENDIX BSCREENING TEST QUALITIES
Page 123 and 124: Screening Test Qualities and Their
Page 125 and 126: APPENDIX CINFECTION PREVENTION PROC
Page 127 and 128: Infection Prevention Processesfor m
Page 129 and 130: Infection Prevention Processeswith
Page 131 and 132: Infection Prevention ProcessesFigur
Page 133 and 134: Table C-4. Preparing and Using Chem
Page 135 and 136: Infection Prevention ProcessesStora
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Page 139 and 140: APPENDIX DTECHNICAL OVERVIEW OF THE
Page 141 and 142: Technical Overview of the Cryothera
Page 143 and 144: Figure D-5. Removing Protector Tube
Page 145 and 146: Technical Overview of the Cryothera
Page 147 and 148: Figure D-11. Gas Cylinder Secured t
Page 149 and 150: APPENDIX ETROUBLESHOOTING WITH THEC
Page 151 and 152: Table E-1. Following-Up on Commonly
Page 153 and 154: APPENDIX FPROCESSING SURGICAL GLOVE
Page 155 and 156: Processing Surgical GlovesTable F-1
Page 157 and 158: Processing Surgical GlovesSTEP 10:
Page 159 and 160: APPENDIX GPERFORMING BREAST AND PEL
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Performing Breast and Pelvic Examin
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Figure G-2. Breast Puckering or Dim
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Figure G-5. Checking for Nipple Dis
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Figure G-18. Speculum in Place with
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APPENDIX HPERCEIVED BARRIERS TO PRO
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AVAILABILITY OF BASIC SUPPLIES AND
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GLOSSARYAcetic AcidAcetowhite Chang
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PatulousSquamocolumnarJunction (SCJ
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ADDITIONAL READINGAlliance for Cerv
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