Why cervical cancer prevention need
•Download as PPTX, PDF•
2 likes•203 views
Myanmar is one of the high cervical cancer countries. as a resource poor country, VIA and Cryotherapy are the effective preventive approach.
More Related Content
What's hot
What's hot (20)
Similar to Why cervical cancer prevention need
Similar to Why cervical cancer prevention need (20)
More from Min Zaw
More from Min Zaw (20)
Recently uploaded
Recently uploaded (20)
Why cervical cancer prevention need
- 2. Incidence rate per 100,000 females (2005)
- 3. Death from Cx Ca in developing countries 80% 85% 90% 95% 100% 2002 2008 2030 GLOBOCAN 2008 report
- 4. Cx Ca situation at a glance in Myanmar 2nd most common Cancer in women and Asian countries? 15.8 15.4 25.4 World SEA Myanmar Crude incidence rate (100,000 women/year)
- 5. Myanmar women at risk 13-million
- 6. What causes Cx Ca? HPV as main cause Sex as transmission mode
- 7. Period from HPV infection to cancer HPV infected 10 – 20 years 10 – 15 years
- 8. Natural history of CIN 57% 43% 32% 32% 11% 1% 35% 22% 5% 56% 12% CIN 1 Mild dysplasia CIN 2 Mod dysplasia CIN 3 Severe dysplasia Regress Persist Progress to CIS Progress to invasion Int J Gyne Path 1993; 12:186-192
- 9. The consequences of HPV infection 90% heal within 2 years 0.8% develop Ca HPV into Cx cells thro’ micro-abrasion
- 10. Can we prevent the progress to cancer? If we can detect cervical epithelial abnormality… and If we can remove it. It is called “Screen and Treat” approach.
- 11. The age to get screening + 25 – 65 years
- 12. The screening tests Cytology HPV test VIA
- 13. Different screening tests for precancerous Cx Pap smear HPV test VIA Which is the most suitable for the resource poor? Correctly identified Correctly excluded 38-84% 50-95% 56-94% >90% 84% 74-94% Easy-to-perform Lab facilities No Lab Comprehensive cervical cancer control : a guide to essential practice, WHO, 2006 Lab facilities
- 14. VIA map (2011) VIA as National program VIA as Pilot program No VIA program
- 15. If she has no evidence of Ca Cx, will she be free from Ca Cx throughout her life time? No! Risk reduction 1 time per life time 2 time per life time 3 time per life time Every 3 years Every 2 years Every year 17 – 32% 29 – 42% 35 – 55% 75 – 88% 86 – 91% 90 – 93%
- 17. Loop Electrosurgical Excision Procedure Electricity or Battery Specialist Anesthesia (Local) Bleeding
- 18. Cold Knife Cone (Conization) Electricity Specialist Anesthesia (General) Bleeding ↑↑
- 20. Treatment options for pre-cancer cervix Cryotherapy LEEP Cold knife cone Effectiveness Setting Direct medical Cost 86 – 95% 91 – 98% 90 – 94% Clinic Hospital Hospital 16-45$ 100-320$ Which is the most suitable for the resource poor? Comprehensive cervical cancer control : a guide to essential practice Pg 140, WHO, 2006 Cost-effectiveness of Cx Ca in India and Thai, NEJM 353:20, Nov, 2005 210-490$ In a place where there are no electricity and anesthetist
- 21. Single Visit Approach Total time for the service - <20 minutes (Screen & Treat)
- 22. Thanks If we can effectively “screen & Treat”