Reference Manual - IARC Screening Group

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ABBREVIATIONS AND ACRONYMSAATACCPAIDSARVASCUSCDCCINCISDHLYFCFHAARTHBVHGSILHIVHLDHPV<strong>IARC</strong>LEEPLGSILPap smearPLWHAROCSCJSILSTIT-zoneUNAIDSUSVIAVIAMWHOAcetic acid testAlliance for Cervical Cancer PreventionAcquired immunodeficiency syndromeAntiretroviralAtypical cells of uncertain significanceThe US Centers for Disease Control and PreventionCervical intraepithelial neoplasiaCarcinoma in situDiscounted health life yearFreeze-clear-freezeHighly active antiretroviral therapiesHepatitis B virusHigh-grade squamous intraepithelial lesionHuman immunodeficiency virusHigh-level disinfectionHuman papillomavirusInternational Agency for Research on CancerLoop electrosurgical excision procedureLow-grade squamous intraepithelial lesionPapanicolaou smearPeople living with HIV/AIDSReceiver operating characteristicSquamocolumnar junctionSquamous intraepithelial lesionSexually transmitted infectionTransformation zoneThe Joint United Nations Programme on HIV/AIDSUnited StatesVisual inspection with acetic acidVisual inspection with acetic acid and magnificationWorld Health OrganizationxiiCervical Cancer Prevention Guidelines for Low-Resource Settings
ONEINTRODUCTIONMAGNITUDE OF THE PROBLEMCervical cancer is an important health problem for women throughout theworld. It is the third most common cancer in women—affecting morethan 1.4 million women worldwide (Ferlay et al. 2001). Each year, morethan 460,000 new cases occur and about 231,000 women die of thedisease (Parkin 2000; Sherris and Herdman 2000).As shown in Figure 1-1, cervical cancer is a particularly significantproblem in developing countries, where about 80% of new cervicalcancer cases occur every year.Figure 1-1. Estimated Number of New Cervical Cancer Cases per YearSource: Parkin 2000.BACKGROUNDNearly all (99.7%) cervical cancers are directly linked to previousinfection with one or more types of human papillomavirus (HPV), one ofthe most prevalent sexually transmitted infections in the world (Judson1992; Walboomers et al. 1999). Of the more than 50 types of HPV thatinfect the genital tract, 15 to 20 types are linked to cervical cancer. Fourof those types—16, 18, 31, and 45—are most often detected in cervicalcancer cases, and type 16 accounts for half of the cases worldwide(Bosch et al. 1995).HPV infections often do not cause symptoms. The most common signs ofinfection are small pink or red warts that appear in the genital area andCervical Cancer Prevention Guidelines for Low-Resource Settings 1-1
Page 1: Cervical Cancer PreventionGuideline
Page 5: TABLE OF CONTENTSPREFACE AND ACKNOW
Page 8: How to High-Level Disinfect Surgica
Page 11 and 12: Table C-2Figure C-1Preparing a Dilu
Page 13: PREFACE AND ACKNOWLEDGMENTSThis ref
Page 17 and 18: IntroductionFigure 1-3. Incidence o
Page 19 and 20: Introductionprevalence areas, a sta
Page 21 and 22: Table 1-2. Reduction in Cumulative
Page 23 and 24: Introductiontheir performance was t
Page 25 and 26: Introductionlesions, or a false pos
Page 27 and 28: IntroductionCompared to other metho
Page 29 and 30: Introductionsignificantly to women
Page 31 and 32: IntroductionBelinson JL et al. 2001
Page 33 and 34: IntroductionMitchell MF et al. 1998
Page 35 and 36: IntroductionYlitalo N et al. 1999.
Page 37 and 38: TWOHUMAN PAPILLOMAVIRUS AND CERVICA
Page 39 and 40: Human Papillomavirus and Cervical C
Page 47 and 48: THREEPATHOPHYSIOLOGY OF CERVICAL CA
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Page 51 and 52: Pathophysiology of Cervical Cancerp
Page 53 and 54: Pathophysiology of Cervical CancerP
Page 55 and 56: Pathophysiology of Cervical CancerI
Page 57 and 58: Pathophysiology of Cervical CancerR
Page 59 and 60: FOURTALKING WITH WOMEN ABOUTCERVICA
Page 61 and 62: Talking with Women About Cervical C
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Talking with Women About Cervical C
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Talking with Women About Cervical C
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FIVEPREVENTING INFECTIONS INHEALTHC
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Preventing Infections in Healthcare
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SIXCLIENT ASSESSMENT AND VIA TESTIN
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Client Assessment and VIA TestingFi
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Client Assessment and VIA TestingIN
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Client Assessment and VIA Testingst
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Client Assessment and VIA Testingsp
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Client Assessment and VIA Testingth
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SEVENTREATMENT AND FOLLOWUPBACKGROU
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Treatment and Followupregardless of
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Treatment and FollowupFigure 7-1. L
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Treatment and FollowupTable 7-6. Co
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Treatment and FollowupFigure 7-2 is
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Treatment and Followup• Regulator
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Treatment and FollowupCRYOTHERAPY P
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Treatment and FollowupStep 6 Point
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Treatment and FollowupNote: When CO
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Treatment and FollowupStep 5Advise
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Treatment and FollowupBerget A, B A
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APPENDIX ATESTS FOR CERVICAL CANCER
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Tests for Cervical Cancer Screening
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APPENDIX BSCREENING TEST QUALITIES
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Screening Test Qualities and Their
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APPENDIX CINFECTION PREVENTION PROC
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Infection Prevention Processesfor m
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Infection Prevention Processeswith
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Infection Prevention ProcessesFigur
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Table C-4. Preparing and Using Chem
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Infection Prevention ProcessesStora
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Infection Prevention Processes• h
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APPENDIX DTECHNICAL OVERVIEW OF THE
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Technical Overview of the Cryothera
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Figure D-5. Removing Protector Tube
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Technical Overview of the Cryothera
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Figure D-11. Gas Cylinder Secured t
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APPENDIX ETROUBLESHOOTING WITH THEC
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Table E-1. Following-Up on Commonly
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APPENDIX FPROCESSING SURGICAL GLOVE
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Processing Surgical GlovesTable F-1
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Processing Surgical GlovesSTEP 10:
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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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innovating to save liveswww.jhpiego
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Reference Manual - IARC Screening Group

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