URC Helps Cambodia Ministry of Health Prepare for Cervical Cancer-screening Program

Cervical cancer is the most common cancer in women in Cambodia, with approximately 1500 new cases diagnosed each year. At least half of these women arrive too late to cure, resulting in deaths that could be prevented through HPV (Human Papillomavirus) vaccination and earlier detection. Worldwide, 70% of cervical cancers are caused by only two HPV types. Cervical cancer screening is currently available in Cambodia only through certain private practitioners and clinics run by nongovernmental organizations.

Age-specific incidence rates of cervical cancer in Cambodia compared to estimates in South-Eastern Asia and the World (source: WHO)
Age-specific incidence rates of cervical cancer in Cambodia  compared to estimates in South-Eastern Asia and the World  (source: WHO)

With support from the USAID Better Health Services Project (BHS) implemented by URC in Cambodia, the Preventive Medicine Department of the Ministry of Health and its partners are collaborating to expand the availability of cervical cancer screening to the general population. They have adopted protocols that follow the latest World Health Organization guidelines, where women aged 30–49 are invited for an initial screening, followed by another screening every five years until age 49. Screening will be done using the VIA method,[1] the recommended screening method for low-resource settings. Screening will be performed by specially trained midwives at health centers. Women with an abnormal VIA result will be offered treatment with cryotherapy and followed up after one year.

The Preventive Medicine Department, Marie Stopes International, and EPOS are currently planning to pilot the cervical cancer screen-and-treat program in several locations in order to determine the best model for nationwide implementation. BHS's role is to help coordinate the effort in order to maximize learning and to contribute its expertise in research and evaluation, behavior change communication, community mobilization, and training. BHS is also leading the drafting of standard operation procedures that will guide the program and is helping partners address the key tasks in their pilots. Since invasive cancer is also detected by a screening program, the Preventive Medicine Department with support from BHS and other partners is studying ways to ensure the referral chain effectively directs women with such cancer to appropriate follow-up care.

URC is also working to improve cervical cancer prevention, screening, and treatment services elsewhere. In Mongolia, we are assisting the Ministry of Health to increase and improve the quality of cervical cancer screening using VIA screening and to implement a national HPV vaccination campaign. The USAID Primary Health Care Project in Iraq implemented by URC developed guidelines and training materials on breast and cervical cancer for primary health care providers. Our Health Care Improvement Project conducted assessments in Europe and Eurasia to evaluate recommended prevention, screening, and treatment services for cervical cancer and other noncommunicable diseases.


[1]Visual Inspection with Acetic acid.

Date 
May 10, 2013
Authors 
Jerker Liljestrand, Team Leader, Maternal and Newborn Health and Family Planning, USAID Better Health Services Project
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