Cervical Cancer Prevention

Clinical Social Franchise Network in Myanmar

Cervical cancer situation at a glance in Myanmar

16/100,000 women in Asia

2nd most common Cancer in Myanmar women

Women at risk >15 years – 18 millions

Annual # Ca Cx women – 5017*

Cervical cancer screening coverage – 0.9%

(*WHO/ICO HPV information center, Jan 2010)

How does HPV infection cause cancer?Pre-Invasive Cancer Invasive Cancer

HPV infected Early abn Advanced Abn

Localized Ca

10 – 15 years 10 – 15 years

Diagnostic methods for pre-cancer cervix

Pap smear

HPV test

VIA

Which is the most suitable for you?

Easy to perform Cost

Difficult

Moderate

Easy

9.38$

31.88$

2.05$

Sensitivity

46%

77%

Cost and benefits of different strategies to screen for cervical cancer in less developed countries,Jeanne S. Mandelblatt et al. Jr of the National Cancer Institute, Vol.94, No.19, Oct, 2002

79%

Treatment options for pre-cancer cervix

Cryotherapy

LEEP

Surgical excision

Easy to perform Setting Effectiveness

Easy

Difficult

Difficult

Clinic

Hospital

Hospital

90%

95%

Which is the most suitable for you?

Source of effectiveness: Cervical Cancer Prevention fact sheet, ACCP

251 SQH outlets in 117 townships

High skills for pelvic exam

Opportunity to check cervix

Already existing instrument

SQH IUD outlets for CCP

Added cost to existing program

Single Visit Approach

Total time for the service - <20 minutes

(Screen & Treat)

Current status for CCP initiation

Training in July, 2011

Advocating to DoH

TOP and SQH outlets for the service

Re-adjustment on CCP due to unexpected high cost of cryo units

Technical advocacy to DoH for CCP

Thanks