Alternative cervical cancer prevention in low‐resource settings: Experiences of visual inspection by acetic acid with single‐visit approach in the first five provinces of Thailand

Background:  After the confirmation of its safety, acceptability and feasibility in a cervical cancer prevention demonstration project in 2002, a visual inspection by acetic acid (VIA) followed by an effective treatment using cryotherapy as a single‐visit approach (SVA) was recently introduced in five provinces having low Pap smear screening rates, in Thailand. The effectiveness of a screening program is usually associated with a high level of coverage; however, in low‐resource settings such a high coverage is still hard to attain by the conventional Pap smear approach. Aims:  To evaluate whether VIA/SVA can increase women's access to the prevention services in low‐resource provinces of Thailand. Methods:  A cross‐sectional study was conducted by analysing electronic screening records of the provinces. A χ 2 test was used in the comparisons of screening coverage between the year before and the first year of VIA/SVA implementation during 1998–2005. Results:  This comparative study, which included 88 554 screening visits totally, shows a significant increase in the screening coverage of five provinces after the VIA/SVA implementation ( P <  0.001). As a result of the large substitution of VIA/SVA for Pap smears, the costs of screening were lowered by as much as $US362 300 (66.8%) in the first year. Conclusion:  VIA/SVA has provided good screening coverage and lowered the financial burden in five low‐resource provinces of Thailand. Therefore, it is promisingly competitive as a potential alternative means of cervical cancer prevention in low‐resource areas.