Collabora'on to Prevent and Control Cervical Cancer in La'n America and the Caribbean

Transcription

1 Collabora'on to Prevent and Control Cervical Cancer in La'n America and the Caribbean Partnership between PAHO- USG- ACS- RINC Mona Saraiya, MD, MPH CDC Associate Director for Cancer Control World Cancer Congress December 6, 2014

2 CERVICAL CANCER IN THE AMERICAS NORTH AMERICA: 14,400 new cases per year 7,100 deaths per year La'n America and the Caribbean: 68,800 new cases per year 28,600 deaths per year Age standardized mortality rate Source: Globocan 2012

3 LIFE COURSE APPROACH TO PREVENT HPV INFECTION AND CERVICAL CANCER PRIMARY PREVENTION SECONDARY PREVENTION TERTIARY PREVENTION HPV vaccina'on Health educa'on Adolescent health services Screening and pre- cancer treatment HPV Pap test VIA test cryotherapy colposcopy LEEP, etc Diagnosis and Treatment pathology surgery radiotherapy chemotherapy care care source: WHO Guidance Note. Comprehensive Cervical Cancer Prevention and Control. 2012

4 PAHO REGIONAL PLAN OF ACTION FOR CERVICAL CANCER PREVENTION AND CONTROL 1. Conduct a situa'on assessment 2. Intensify informa'on, educa'on and counseling 3. For'fy screening and pre- cancer treatment programs 4. Establish or stengthen informa'on systems and cancer registries 5. Improve access and quality of cancer treatment and of pallia've care 6. Generate evidence to facilitate decision making regarding HPV vaccine introduc'on 7. Advocate for equitable access and affordable comprehensive cervical cancer preven'on

5 PAHO REGIONAL PLAN OF ACTION FOR CERVICAL CANCER In se\ngs with sufficient resources to sustain quality Pap test screening and guarantee 'mely and appropriate follow up for women screened posi've, strengthen screening programs by : Improving the quality of screening tests, and consider introducing HPV DNA tes'ng Increasing the screening coverage of women in the at risk age group (>30 years) Increasing the propor'on of 'mely and appropriate follow up care for women with abnormal screening test results

6 PAHO REGIONAL PLAN OF ACTION FOR CERVICAL CANCER In se\ngs where resources are not sufficient to sustain quality Pap test screening and where there is limited access to 'mely and appropriate follow- up care : Consider incorpora'ng a single visit screen and treatment approach This involves screening women with VIA followed by immediate treatment of precancerous lesions with cryotherapy This approach can be easily carried out from primary health care services or through outreach campaigns

7 Collabora'on to Prevent and Control Cervical Cancer in La'n America and the Caribbean OVERALL GOAL: Reduce cervical cancer deaths Objec've: Increase access to high quality cervical cancer and control services Specific objec'ves: 1. Increase public awareness 2. Promote policy changes 3. Strengthen cervical cancer programs 4. Build the evidence- base through research

8 Multi-Sector Partnership Pan American Health Organiza'on (PAHO) Network of La'n American Na'onal Cancer Ins'tu'ons (RINC) US Government Department of Health and Human Services (HHS) Centers for Disease Control and Preven'on (CDC) Na'onal Cancer Ins'tute American Cancer Society (ACS)

9 1. Increase Public Awareness: Project Ac'vi'es in 2014 American and Caribbean female leaders event at the U.N.G.A. 2. Promote Policy Changes: policy forums to disseminate new WHO guidelines El Salvador Costa Rica Guatemala 3. Strengthen cervical cancer programs: HPV manual and regional Dialogue with HPV manufacturers Technical exchanges/training workshops on VIA screening Bolivia Curriculum development for FETP and nurses 4. Opera'onal research: Support of ESTAMPA project

10 Cervical Cancer Policy Forum in El Salvador q Held March 2014 q q q q Mul'- sector representa'on: MOH Providers Basic Health Intn l and other NGOs PAHO CDC Discussions on WHO screening guidelines in context na'onal program July 2014 follow- up mee'ng MOH made decision to implement CareHPV tes@ng na@onwide over the next 5 years CDC, PAHO, and partners will provide support

11 Cervical Cancer Policy Forum in Costa Rica q Held March 2014 q Mul'- sector representa'on: MOH US NCI PAHO CDC q Present results and lessons learned from the Guanacaste project q Discussions on WHO screening guidelines in context na'onal program

12 HPV Tes'ng Manual q Manual for managers implemen'ng an HPV- based screening program q Group of experts and program implementers: Argen'na, Colombia, El Salvador, Mexico, Trinidad & Tobago, IARC, PATH, CDC, OPS q Met 3-4 'mes to plan full program

13 Table of Contents 1: Scien'fic Evidence about the HPV test 2. Summary of Available HPV Tests around the World 3. Costs for an HPV- based program 4: How to begin? 5: Implementa'on 6: Laboratory Opera'onal Aspects 7: Managing HPV results 8: Communica'ons 9: Alterna've strategies: Automa'ons 10: Evalua'on 11. Lessons Learned

14 Upcoming Ac'vi'es: CDC Cancer Training Curriculum q 5 Modules, Case Studies and Field Exercises (40+ hrs): Introduc'on to Cancer Epidemiology, Preven'on and Control Principles of Comprehensive Cancer Control Cancer Registries Cancer Screening Programs Applied Research q Pilots planned with Field Epidemiology Training Programs (FETPs) in India and La'n America in early 2015 q Training materials available / open- access in 2015

15 Ø 2500 FETP graduates worldwide Field Epidemiology Training Programs

16 AVAILABLE RESOURCES Screen and treat guideline Guidance note Program manager manual Cytology screening guide VIA based screening guide Cryotherapy treatment guide

17 Thanks and Ques'ons? For more informa'on please contact Centers for Disease Control and Preven'on 1600 Cli]on Road NE, Atlanta, GA Telephone, CDC- INFO ( )/TTY: E- mail: Web: Center for Chronic Disease and Health Division of Cancer and Control