RHO : Topics : Cervical Cancer Prevention

Cervical Cancer Consultative Group:
Ten Priority Questions Regarding Cervical Cancer Prevention in Developing Countries

The following questions were developed by representatives of AVSC International, the JHPIEGO Corporation, PATH (Program for Appropriate Technology in Health) and the U.S. Agency for International Development, who met in 1997 to evaluate research and programming needs. The group evaluated a list of 30 questions that could be answered through medical or operations research, policy or cost analysis, or development of programming or research guidelines. From among these questions, 10 were identified as high priority. These questions were selected based on the following criteria: they can be answered in 2 to 3 years; they are not being fully addressed; they can be answered, in part, by supplementing ongoing projects and activities in specific countries; their answers can facilitate the design of effective programs in low-resource settings; and their answers will respond to the concerns of donors, aid agencies, women's health advocates, and program managers and planners.

1. What are the sensitivity and specificity of visual inspection (aided and unaided)? How can specificity be maximized?

2. What are the common side effects of LEEP and cryotherapy?

3. What characteristics define the target group for which screening has the most impact?

4. When should low-grade dysplasia be treated?

5. How effective are the requirements for integrating cervical cancer prevention interventions into existing health and family planning services?

6. How do we ensure that policy makers implement effective program strategies? How are cervical cancer resources expended now?

7. What are the perspectives of clients, providers, program managers, women's health advocates, and others regarding cervical cancer control? What are the implications of these perspectives for the design of appropriate control programs?

8. How do various screening approaches perform in routine settings in terms of sensitivity and specificity, coverage and cost-effectiveness?

9. What are women's experiences with LEEP and cryotherapy?

10. What level of support is needed to maintain high-quality cervical cancer prevention services (such as in equipment and provider skills, among others)?

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