Reference Manual - IARC Screening Group

More documents

Recommendations

Info

Treatment and FollowupTable 7-7. Recommended Referral ActionsVIA FINDINGWomen suspected of having cervicalcancerTest-positive women whose lesionsoccupy greater than 75% of the cervix,extend into the vaginal wall or extendmore than 2 mm beyond thecryotherapy probe including the tip ofthe probeTest-positive women who fulfillcriteria for immediate treatment butwho request to be treated using aprocedure other than cryotherapyTest-positive women who requestfurther (more diagnostic) testing, notoffered at the siteTest-positive women declining anytreatmentREFERRAL ACTIONRefer immediately to a facility that canadequately provide treatment for invasivecancer.Refer for assessment and treatment at thenearest facility offering LEEP or conebiopsy. If travel to the other facility is notpossible or judged not likely to happen,then counsel about the greater likelihoodof persistence of the lesion at 12 monthsand the need for retreatment.Counsel about advantages anddisadvantages of all treatment methods.Refer to closest facility offering treatmentof their choice.Refer to closest facility offeringcolposcopy and biopsy (as indicated).Counsel about the likelihood of diseaseprogression and prognosis. Recommend areturn visit within a year for a repeat VIAtest to reassess disease status.Once a woman is assessed as eligible for treatment, the healthcareprovider should explain to her the meaning and implications of the testresults. Next, s/he should explain in more detail what the treatmentprocedure involves, including the benefits, risks, potential side effectsand their management, and advantages and disadvantages of immediatetreatment. Then the woman should make an informed choice regardingtreatment. Her verbal or written consent (consistent with local norms)and choice of treatment should be recorded where indicated on the reportform (Figure 6-2, page 6-4). Next, she should be shown a comfortableplace to sit until cryotherapy can be performed. Waiting time fortreatment should not be longer than 1–2 hours.Women assessed as test-positive who have evidence of purulentcervicitis 3 can be given a single oral dose of two antibiotics (1 gazithromycin for Chlamydia trachomatis 4 and 250 mg ciprofloxin forNeisseria gonorrhoeae) prior to cryotherapy. They can be offered thechoice of either having cryotherapy immediately (the same day as takingantibiotics) or returning in 2 weeks after antibiotic treatment for repeatVIA and cryotherapy. Providing antibiotic treatment to women suspectedof having purulent cervicitis may potentially reduce the very small risk(less than 1%) of pelvic infection following cryotherapy.3 Purulent cervicitis is defined as yellowish mucopus in the cervical os or canal, a cervix that is beefy red and bleedseasily when touched, or a urethral discharge.4 Doxycycline (100 mg orally, 2 times daily for 7 days) is an acceptable alternative, but compliance is poor. Doxycyclineshould not be used in pregnancy.7-8 Cervical Cancer Prevention Guidelines for Low-Resource Settings
Treatment and FollowupFigure 7-2 is a sample flow diagram summarizing the possible optionsfor women after VIA testing. It also shows the treatment options for VIAtest-positive women.Figure 7-2. Sample Flow Diagram for Cervical Cancer PreventionCervical Cancer Prevention Guidelines for Low-Resource Settings 7-9
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:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48: THREEPATHOPHYSIOLOGY OF CERVICAL CA
Page 49 and 50: With the onset of puberty, whichis
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
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
Page 85 and 86: Client Assessment and VIA Testingst
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: Treatment and FollowupTable 7-6. Co
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 and 110: Treatment and FollowupStep 5Advise
Page 111 and 112: Treatment and FollowupBerget A, B A
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
Page 137 and 138: Infection Prevention Processes• h
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
Page 161 and 162:
Performing Breast and Pelvic Examin
Page 163 and 164:
Figure G-2. Breast Puckering or Dim
Page 165 and 166:
Figure G-5. Checking for Nipple Dis
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Figure G-18. Speculum in Place with
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
APPENDIX HPERCEIVED BARRIERS TO PRO
Page 207 and 208:
AVAILABILITY OF BASIC SUPPLIES AND
Page 209 and 210:
GLOSSARYAcetic AcidAcetowhite Chang
Page 211 and 212:
PatulousSquamocolumnarJunction (SCJ
Page 213 and 214:
ADDITIONAL READINGAlliance for Cerv
Page 216:
innovating to save liveswww.jhpiego
show all

Reference Manual - IARC Screening Group

Create successful ePaper yourself

Delete template?

Save as template?