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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
Author(s) -
PALANUWONG Buncha
Publication year - 2007
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2006.00680.x
Subject(s) - visual inspection , medicine , cervical cancer screening , cryotherapy , cervical cancer , resource (disambiguation) , environmental health , cancer , computer science , surgery , computer network , artificial intelligence
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.