cancer prevention

cervical cancer

low-income countries, linked to genital infection with HPV, a sexually transmitted disease, mostly 16-18 year olds

cervical cancer prevention

HPV vaccine, primary prevention: 10-14 girls, secondary prevention: Pap smear, HPV tests, tertiary prevention: diagnosis and treatment of invasive cervical cancer and palliative care

WHOs global strategy to accelerate the elimination of cervical cancer as a public health problem

90-70-90 targets to be met by 2030, 90 percent girls vaccinated with HPV by 15, 70 percent women screened with high performance test by 35 and agin by 45 , 90 percent women identified with cervical disease receive treatment

benefits of 90-70-90 targets

low and lower middle income countries, fall of cervical cancer incidence rate and deaths

cervical cancer and HIV

link between HIV and cervical cancer is direct and deadly

A low cost screening method

visual inspection with acetic acid through screening, soaking the cervix for about 5 minutes with regular vinegar

digital cervicography advantages

photos can be saved and reviewed by physicians, can be remotely viewed for real-time physician consultation

recent shift in WHO’s strategy towards HPV testing

encourages countries to use HPV tests for cervical screening, HPV-DNA detects high-risk strains of HPV, HPV mRNA detects infections that lead to cellular transformation, HPV testing is objective as it does not rely on visual inspection and is more cost-effective than pap smears

see and treat approaches

can be done by trained nurses cervicography is accurate and can be sent to an expert anywhere in the world who can assist in real time, screening must be linked to treatment and management of positive screening tests

how does cryotherapy work?

apply probe to cervix for a 30 second freeze and let defrost, repeat one time, not too painful and cheap

HPV vaccine

safe and effective in girls not yet exposed, protects against HPV 16 and 18, protects for at least 8 years but likely much longer

HPV vaccine in kenya

lack of awareness and knowledge, fear of side effects, religion, misinformation, communications with health workers, limited health resources, corruption, cost and need for 3 doses

breast cancer

self breast exams, clinical examination, mammography