Workshop Proceedings: Issues in Cervical Cancer: Seeking Alternatives toCytology. Held in Baltimore, Maryland on March 2-4, 1994

摘要

Cervical cancer is the leading cause of cancer death among women in the ThirdWorld. The report contains the proceedings of a workshop hosted by the Johns Hopkins Program for International Education in Reproductive Health (JHPIEGO) in March 1994 to review alternatives to cytology (i.e., Pap smears) for screening cervical cancer in Third World women. Section I contains an overview of cervical cancer and cervical cancer screening in developing countries. The value of human papillomavirus (HPV) testing, and available treatments in the United States and the developed world for preinvasive cervical lesions. Section II presents papers by international experts on the status of cervical cancer screening in their home countries of Thailand, Kenya, Haiti, and Brazil. Section III first discusses cervicography (photographing the cervix) and low-power optical screening as alternatives to Pap smears, concluding that visual screening of the cervix using either the naked eye or low-power magnification holds considerable promise as a low-cost screening method. Section III also describes a study conducted in India by the Program for Appropriate Technology in Health (PATH) to assess a small monocular lens called the Gynoscope, which was developed to enhance visual inspection of the cervix. Finally, the section concludes with a series of questions to consider in designing a study to test visual screening. Includes references.