Effectiveness, safety and acceptability of the method of visual inspection with acetic acid (VIA) and cryotherapy based single-visit approach to cervical cancer prevention (CCP) in Kungyangon Township, Yangon Region, Myanmar.

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Date
2015-09-01
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Publisher
Myanmar Medical Association
Abstract
Cervical cancer is the second most frequent cancer occurring among the women in Myanmar. Being a preventable cancer, it is crucial to have an organized screening program in place that uses simple, practical and cost effective technology so as to ensure that the screening services have a wide coverage and it is universally accessible. The aim of this study is to fi nd out the effectiveness, safety and acceptability of the method of visual inspection with acetic acid (VIA) and cryotherapy based single-visit approach for use in cervical cancer prevention (CCP) programmes in Myanmar. The study is a descriptive community-based study conducted from July 2013 to October 2014. A well trained central CCP mobile team from Central Women’s Hospital (CWH) of the University of Medicine 1 visited Kungyangon Township fortnightly during the weekends to carry out the study. During the 6 visits undertaken by the team, 1,617 married women between the ages of 30 - 49 years were screened for cervical cancer using VIA method. The screening coverage achieved was 8.97%. The VIA tests were positive in 121 women and the screening positive rate was 7.5%. Cryotherapy was given to 119 eligible women after proper counseling. The treatment rate was 98.35%. Two women needed loop electrosurgical excision procedure (LEEP) surgery. Another two women had invasive cancer on screening. Watery vaginal discharge for 2 to 3 weeks after cryotherapy was the only symptoms reported at the time of one month follow-up. At the time of 1 year follow-up visit, the defaulter rate was 13.45% and 3 women had persistent VIA positive lesions. The overall cure rate was 97.09%. Twenty local basic health staff (BHS) were trained during screening visits of the Central CCP team. A local CCP team was also formed to sustain the screening program at the community level. All women that participated in the study were happy with the single-visit approach and they have been supported by their husbands in their efforts to obtain treatment. In addition, it was found that the women undergoing cryotherapy successfully adhered to home-care instructions prescribed by the CCP team. The study has shown that the screen and treat single-visit approach can be successfully implemented and expanded to other areas so that a universal coverage can be obtained to control cervical cancer in Myanmar.
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Keywords
Cervical cancer, Screening, Prevention, VIA, Cryotherapy, Kungyangon township, Yangon, Myanmar
Citation
Mya Thida, Khin May Thin, Zaw Myint Thein, Yin Yin Sein, Thazin Nyunt, Sanda. Effectiveness, safety and acceptability of the method of visual inspection with acetic acid (VIA) and cryotherapy based single-visit approach to cervical cancer prevention (CCP) in Kungyangon Township, Yangon Region, Myanmar. Myanmar Medical Journal. 2015 September; 57 (3): 48-56.