Feasibility of thermocoagulation in a screen-and-treat approach for the treatment of cervical precancerous lesions in sub-Saharan Africa

BMC Women's Health

Research Article

Bruno Kenfack¹  Eveline Tincho¹  Liliane Temogne¹  Pierre-Marie Tebeu²  Patrick Petignat³  Rosa Catarino³  Ulrike Meyer-Hamme³  Manuela Viviano⁴  Anne-Caroline Benski⁵  Pierre Vassilakos⁶ 

[1] Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon;Department of Gynecology and Obstetrics, University Centre Hospital, Yaoundé, Cameroon;Division of Gynaecology, Department of Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland;Division of Gynaecology, Department of Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland;Division of Gynecology, Geneva University Hospitals, Boulevard de la Cluse 30, 1205, Geneva, Switzerland;Division of Gynaecology, Department of Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland;Saint Damien Medical Centre, Ambanja, Madagascar;Geneva Foundation for Medical Education and Research, Geneva, Switzerland;

关键词: Human papillomavirus (HPV);    Cervical intra-epithelial neoplasia (CIN);    Cervical cancer;    Screen-and-treat;    Thermocoagulation;   

DOI  :  10.1186/s12905-016-0355-x

 received in 2016-06-21, accepted in 2016-12-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe use of thermocoagulation for the treatment of cervical precancerous lesions has recently generated a great deal of interest. Our aim was to determine the feasibility of this outpatient procedure in the context of a cervical cancer (CC) screen-and-treat campaign in sub-Saharan Africa.MethodsBetween July and December 2015, women living in the area of Dschang (Cameroon) aged between 30 and 49 years, were enrolled in a CC screening study.HPV self-sampling was performed as a primary screening test and women who were either “HPV 16/18/45-positive” or “positive to other HPV types and to VIA” were considered screen-positive, thus requiring further management. The primary outcome was the percentage of screen-positive patients who met the criteria to undergo thermocoagulation. The secondary outcome was the assessment of the procedure’s side effects immediately after treatment and at the 1-month follow-up visit.ResultsA total of 1012 women were recruited in the study period. Among 121 screen-positive women, 110 of them (90.9%) were eligible to be treated with thermocoagulation. No patients discontinued treatment because of pain or other side effects. The mean ± SD (Standard Deviation) score measured on the 10-point Visual Analogue Scale (VAS) was 3.0 ± 1.6. Women having less than 2 children were more likely to report a higher pain score than those with more than two (4.2 ± 2.0 versus 2.9 ± 1.5, respectively; p value = 0.016). A total of 109/110 (99.1%) patients came to the 1-month follow-up visit. Vaginal discharge was reported in 108/109 (99.1%) patients throughout the month following treatment. Three patients (2.8%) developed vaginal infection requiring local antibiotics. No hospitalizations were required.ConclusionThe majority of screen-positive women met the criteria and could be treated by thermocoagulation. The procedure was associated to minor side effects and is overall feasible in the context of a CC screen-and-treat campaign in sub-Saharan Africa.Trial registrationThe trial was retrospectively registered on November 11, 2015 with the identifier: ISRCTN99459678.

【 授权许可】

CC BY   
© The Author(s). 2017