Reference Manual - IARC Screening Group

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Human Papillomavirus and Cervical CancerSECONDARY PREVENTIONAs discussed in Chapter 1, although at present prevention of HPVinfection is difficult, for women already infected the immediate need is to:• identify those with early, easily treatable precancerous lesions; and• cost-effectively treat them before the lesions progress to cancer.Thus, the remaining chapters of this manual are devoted to providinghealth professionals working at all levels of the healthcare system withthe necessary new knowledge they need to understand how to managethis problem in low-resource settings where Pap smears are not available.When this knowledge is combined with competency-based training inVIA and cryotherapy, healthcare providers should be able to effectivelycounsel women at risk of cervical cancer and to test, treat or refer womenwith cervical disease.REFERENCESBlumenthal P. 2002. Immunization against cervical cancer: Who? When?Where? Medscape General Medicine 4(4). Available athttp://www.medscape.com/viewarticle/444979.Cason J, P Rice and JM Best. 1998. Transmission of cervical cancerassociatedhuman papilloma viruses from mother to child. Intervirology41(4–5): 213–218.Groopman J. 1999. Contagion. The New Yorker 75(26): 44–49.Judson FN. 1992. Interactions between human papillomavirus and humanimmunodeficiency virus infections. <strong>IARC</strong> Scientific Publications 119:199–207.Koutsky LA et al. 2002. A controlled trial of a human Papillomavirustype 16 vaccine. New England Journal of Medicine 347: 1645–1651.Magnusson P, P Sparen and U Gyllensten. 1999. Genetic link to cervicaltumors. Nature 400: 29–30.Massimi P and L Banks. 1997. Repression of p53 transcriptional activityby the HPV E7 proteins. Virology 227(1): 255–259.McDonald C. 1999. Cancer statistics, 1999: Challenges in minoritypopulations. CA—A Cancer Journal for Clinicians 49(1): 6–7.2-8 Cervical Cancer Prevention Guidelines for Low-Resource Settings
Human Papillomavirus and Cervical CancerMoscicki AB et al. 1999. Risk factors for abnormal anal cytology inyoung heterosexual women. Cancer Epidemiology, Biomarkers &Prevention 8(2): 173–178.Palank C. 1998. An introduction to colposcopy concepts, controversiesand guidelines. ADVANCE for Nurse Practitioners 6(10): 45–50, 91.Roden RB, M Ling and TC Wu. 2004. Vaccination to prevent and treatcervical cancer. Human Pathology 35(8): 971–982.Roden RB, DR Lowy and JT Schiller. 1997. Papillomavirus is resistantto desiccation. Journal of Infectious Diseases 176(4): 1076–1079.Schreckenberger C and AM Kaufman. 2004. Vaccination strategies forthe treatment and prevention of cervical cancer. Current Opinion inOncology 16: 485–491.Stentella P et al. 1998. HPV and intraepithelial neoplasia recurrentlesions of the lower tract: assessment of the immune system. EuropeanJournal of Gynaecological Oncology 19(5): 466–469.Stewart AC et al. 1996. Intratype variation in 12 human papillomavirustypes: A worldwide perspective. Journal of Virology 70(5): 3127–3136.Terai M et al. 1999. High prevalence of human papillomavirus in thenormal oral cavity of adults. Oral Microbiology and Immunology 14(4):201–205.Walboomers JMM et al. 1999. Human papillomavirus is a necessarycause of invasive cervical cancer worldwide. Journal of Pathology189(1): 12–19.Wen LM et al. 1999. Risk factors for the acquisition of genital warts: Arecondoms protective? Sexually Transmitted Infections 75: 312–316.Wright TC et al. 2006. HPV vaccines and screening in the prevention ofcervical cancer; conclusions from a 2006 workshop of internationalexperts. Vaccine 24S3: S3/251–S3/261.Ylitalo N et al. 1999. Smoking and oral contraceptives as risk factors forcervical intraepithelial neoplasia. International Journal of Cancer 81(3):357–365.Cervical Cancer Prevention Guidelines for Low-Resource Settings 2-9
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 and 14: PREFACE AND ACKNOWLEDGMENTSThis ref
Page 15 and 16: ONEINTRODUCTIONMAGNITUDE OF THE PRO
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 41 and 42: Human Papillomavirus and Cervical C
Page 43: 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
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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
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Page 91 and 92: SEVENTREATMENT AND FOLLOWUPBACKGROU
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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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