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Abstract
ABSTRACT
INTRODUCTION. Many procedure of screening and treatment of precancerous lesion of the uterine cervix have being proposed.
OBJECTIVES. The objective of this study was to evaluate the prevention and treatment of the precancerous lesions of the cervix according to the ‘see and treat’ approach.
METHODS. We carried out a prospective and descriptive study in a rural area from 10th February 2011 to 10th February 2012. Precancerous lesions of the cervix were screened on colposcopy after application of acetic acid (VIA) and lugol’s iodine (VILI). Biopsies were taken for histopathology. The data was analyzed using Microsoft excel.
RESULTS. A total of 60 (4,8 %) women were suspected to have cervical dysplasia on visual inspection after application of acetic acid (VIA) and visual inspection after application of lugol’s iodine (VILI) and 01 had a suspicion of cancer. A biopsy was carried out during colposcopy and the patients were immediately treated using Semms cold coagulation. The histology confirmed the dysplasia on 58 cases and 02 cases of invasive cancer. The sensitivity was 39.34 % for IVA and 98.36 % for VILI. The sensitivity was 100 % for colposcopy performed after the above mentioned tests. 22 out of 61 women previously treated came of review; 21 (95.46%) out of 22 did not present any lesions, thus were successfully treated.
CONCLUSION. The screening and treatment of cervical lesions of the uterus after application of Acetic Acid and Lugol’s iodine and colposcopy produces good result. Results are also good after immediate treatment by thermocoagulation. Thus the “see and treat” approach should be introduced in the cervical cancer program procedure in Cameroon.
RÉSUMÉ
INTRODUCTION. Plusieurs approches de prévention et de prise en charge du cancer et des lésions précancéreuses sont souvent proposées.
OBJECTIF. Évaluer la prise en charge des lésions précancéreuses du col utérin en campagne de masse selon l’approche « voir et traiter ».
MATÉRIELS ET MÉTHODES. Il s'agit d'une étude descriptive et prospective qui s’est déroulée dans une période allant du 10 Févier 2011 au 10 février 2012 en zone rurale. Les lésions précancéreuses du col utérin étaient dépistées à la colposcopie et après application de l’acide acétique (IVA) et du Lugol (IVL). Les lésions étaient traitées par thermo coagulation après biopsie pour histopathologie.
RÉSULTATS. Un total de 60 (4,8 %) des 1248 femmes dépistées ont eu des lésions de dysplasie cervicale à l'inspection visuelle après application de l'acide acétique (IVA) ou après inspection visuelle après application du Lugol (IVL) et 01 femme, une suspicion de cancer. Elles ont bénéficié d'une colposcopie, d'une biopsie dirigée percolposcopique puis traitées par électrodiathermie. L’histopathologie a par la suite confirmé la dysplasie sur 58 cas, et 02 cas de cancer invasif. La sensibilité était de 39,34 % pour IVA et 98,36 % pour IVL. La sensibilité de la colposcopie a été de 100% pour le diagnostic des lésions précancéreuses ou de cancer. Vingt- deux des 61 femmes traitées antérieurement ont été revues après un an ; 21 ont présenté un contrôle satisfaisant faisant un taux de guérison de 95,46 %.
CONCLUSION. Le dépistage des lésions cervicales par tests visuels à l’acide acétique et au Lugol, couplé à la colposcopie donne de bons résultats ainsi que le traitement immédiat par thermocoagulation. L’approche « voir et traiter » peut être introduite dans l’algorithme de dépistage et traitement des dysplasies du col utérin au Cameroun.
Article Details
References
- WHO. World Health Organization. GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012. 2012.
- Sando Z, Fouogue JT, Fouelifack FY, Fouedjio JH, Mboudou ET, Oyono JL. Profil des cancers gynécologiques et mammaires à Yaoundé - Cameroun. Pan Afr Med J [Internet]. 2014 [cited 2011 Jan 11];17. Available from: http://www.panafrican-med-journal.com/content/article/17/28/full/
- Tebeu PM, Sando Z, Ndoumba A, Sandjong I, Mawech-fauceglia P, Doh A. Prevalence and Geographical Distribution of Precancerous Lesions of the Uterine Cervix in Cameroon. J Cytol Histol [Internet]. 2013 [cited 2011 Jan 11];04(04). Available from: http://www.omicsonline.org/prevalence-and-geographical-distribution-of-precancerous-lesions-of-the-uterine-cervix-in-cameroon-2157-7099.1000183.php?aid=19109
- CNLC. Comité National de Lutte contre le cancer. Guide d’information. 2007.
- Tebeu PM, Sandjong I, Nkele N, Fokoua S, Achu P, Kouam L, et al. Lesions pre cancereuses du col uterin en zone rurale : Etude transversale. Médecine Afr Noire. 52(1):27–31.
- Doh AS, Nkele NN, Achu P, Essimbi F, Essame O, Nkegoum B. Visual inspection with acetic acid and cytology as screening methods for cervical lesions in Cameroon. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2005 May;89(2):167–73.
- WHO. WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. 2013.
- Chanen W. Electrocoagulation diathermy. Baillières Clin Obstet Gynaecol. 1995 Mar;9(1):157–72.
- Chanen W, Rome RM. Electrocoagulation diathermy for cervical dysplasia and carcinoma in situ: a 15-year survey. Obstet Gynecol. 1983 Jun;61(6):673–9.
- Ghosh P, Gandhi G, Kochhar PK, Zutshi V, Batra S. Visual inspection of cervix with Lugol’s iodine for early detection of premalignant & malignant lesions of cervix. Indian J Med Res. 2012 Aug;136(2):265–71.
- Blumenthal PD, Lauterbach M, Sellors JW, Sankaranarayanan R. Training for cervical cancer prevention programs in low-resource settings: focus on visual inspection with acetic acid and cryotherapy. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2005 May;89 Suppl 2:S30–37.
- Ekalaksananan T, Pientong C, Thinkhamrop J, Kongyingyoes B, Evans MF, Chaiwongkot A. Cervical cancer screening in north east Thailand using the visual inspection with acetic acid (VIA) test and its relationship to high-risk human papillomavirus (HR-HPV) status. J Obstet Gynaecol Res. 2010 Oct;36(5):1037–43.
- Akinola OI, Fabamwo AO, Oshodi YA, Banjo AA, Odusanya O, Gbadegesin A, et al. Efficacy of visual inspection of the cervix using acetic acid in cervical cancer screening: a comparison with cervical cytology. J Obstet Gynaecol J Inst Obstet Gynaecol. 2007 Oct;27(7):703–5.
- Sankaranarayanan R, Wesley R, Thara S, Dhakad N, Chandralekha B, Sebastian P, et al. Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol’s iodine (VILI) in cervical cancer screening in Kerala, India. Int J Cancer J Int Cancer. 2003 Sep 1;106(3):404–8.
- Sarian LO, Derchain SF, Naud P, Roteli-Martins C, Longatto-Filho A, Tatti S, et al. Evaluation of visual inspection with acetic acid (VIA), Lugol’s iodine (VILI), cervical cytology and HPV testing as cervical screening tools in Latin America. This report refers to partial results from the LAMS (Latin AMerican Screening) study. J Med Screen. 2005;12(3):142–9.
- Pretorius RG, Belinson JL. Colposcopy. Minerva Ginecol. 2012 Apr;64(2):173–80.
- Cárdenas-Turanzas M, Follen M, Benedet J-L, Cantor SB. See-and-treat strategy for diagnosis and management of cervical squamous intraepithelial lesions. Lancet Oncol. 2005;6(1):43–50.
- Woodman CB, Jordan JA, Mylotte MJ, Gustafeson R, Wade-Evans T. The management of cervical intraepithelial neoplasia by coagulation electrodiathermy. Br J Obstet Gynaecol. 1985 Jul;92(7):751–5.
References
WHO. World Health Organization. GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012. 2012.
Sando Z, Fouogue JT, Fouelifack FY, Fouedjio JH, Mboudou ET, Oyono JL. Profil des cancers gynécologiques et mammaires à Yaoundé - Cameroun. Pan Afr Med J [Internet]. 2014 [cited 2011 Jan 11];17. Available from: http://www.panafrican-med-journal.com/content/article/17/28/full/
Tebeu PM, Sando Z, Ndoumba A, Sandjong I, Mawech-fauceglia P, Doh A. Prevalence and Geographical Distribution of Precancerous Lesions of the Uterine Cervix in Cameroon. J Cytol Histol [Internet]. 2013 [cited 2011 Jan 11];04(04). Available from: http://www.omicsonline.org/prevalence-and-geographical-distribution-of-precancerous-lesions-of-the-uterine-cervix-in-cameroon-2157-7099.1000183.php?aid=19109
CNLC. Comité National de Lutte contre le cancer. Guide d’information. 2007.
Tebeu PM, Sandjong I, Nkele N, Fokoua S, Achu P, Kouam L, et al. Lesions pre cancereuses du col uterin en zone rurale : Etude transversale. Médecine Afr Noire. 52(1):27–31.
Doh AS, Nkele NN, Achu P, Essimbi F, Essame O, Nkegoum B. Visual inspection with acetic acid and cytology as screening methods for cervical lesions in Cameroon. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2005 May;89(2):167–73.
WHO. WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. 2013.
Chanen W. Electrocoagulation diathermy. Baillières Clin Obstet Gynaecol. 1995 Mar;9(1):157–72.
Chanen W, Rome RM. Electrocoagulation diathermy for cervical dysplasia and carcinoma in situ: a 15-year survey. Obstet Gynecol. 1983 Jun;61(6):673–9.
Ghosh P, Gandhi G, Kochhar PK, Zutshi V, Batra S. Visual inspection of cervix with Lugol’s iodine for early detection of premalignant & malignant lesions of cervix. Indian J Med Res. 2012 Aug;136(2):265–71.
Blumenthal PD, Lauterbach M, Sellors JW, Sankaranarayanan R. Training for cervical cancer prevention programs in low-resource settings: focus on visual inspection with acetic acid and cryotherapy. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2005 May;89 Suppl 2:S30–37.
Ekalaksananan T, Pientong C, Thinkhamrop J, Kongyingyoes B, Evans MF, Chaiwongkot A. Cervical cancer screening in north east Thailand using the visual inspection with acetic acid (VIA) test and its relationship to high-risk human papillomavirus (HR-HPV) status. J Obstet Gynaecol Res. 2010 Oct;36(5):1037–43.
Akinola OI, Fabamwo AO, Oshodi YA, Banjo AA, Odusanya O, Gbadegesin A, et al. Efficacy of visual inspection of the cervix using acetic acid in cervical cancer screening: a comparison with cervical cytology. J Obstet Gynaecol J Inst Obstet Gynaecol. 2007 Oct;27(7):703–5.
Sankaranarayanan R, Wesley R, Thara S, Dhakad N, Chandralekha B, Sebastian P, et al. Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol’s iodine (VILI) in cervical cancer screening in Kerala, India. Int J Cancer J Int Cancer. 2003 Sep 1;106(3):404–8.
Sarian LO, Derchain SF, Naud P, Roteli-Martins C, Longatto-Filho A, Tatti S, et al. Evaluation of visual inspection with acetic acid (VIA), Lugol’s iodine (VILI), cervical cytology and HPV testing as cervical screening tools in Latin America. This report refers to partial results from the LAMS (Latin AMerican Screening) study. J Med Screen. 2005;12(3):142–9.
Pretorius RG, Belinson JL. Colposcopy. Minerva Ginecol. 2012 Apr;64(2):173–80.
Cárdenas-Turanzas M, Follen M, Benedet J-L, Cantor SB. See-and-treat strategy for diagnosis and management of cervical squamous intraepithelial lesions. Lancet Oncol. 2005;6(1):43–50.
Woodman CB, Jordan JA, Mylotte MJ, Gustafeson R, Wade-Evans T. The management of cervical intraepithelial neoplasia by coagulation electrodiathermy. Br J Obstet Gynaecol. 1985 Jul;92(7):751–5.