PATH is introducing smart, low-cost methods to help Myanmar practitioners screen women for cervical cancer and save lives by treating precancerous lesions. Cervical cancer should never be fatal. The human papillomavirus (HPV) infects nearly every sexually active person. Most people are able to clear the virus and do not experience advanced disease. But for some women the infection persists over years, developing to a precancerous stage and years later to invasive cervical cancer. More than a half-million cases of cervical cancer occur each year and about 266,000 women die, with 85 percent of mortality happening in the developing world.
In Myanmar, cervical cancer has become one of the most common cancers among women. PATH is working with the Ministry of Health to stop the spread of this disease through new and easy methods for screening that do not rely on sophisticated laboratories and can deliver quick results and easy low-cost treatments. This method, called visual inspection with acetic acid (VIA), involves swabbing the cervix with vinegar (5% acetic acid) and looking for areas that turn white, which indicates they are likely to be precancerous or cancerous. The provider can then remove the abnormal tissue on the spot using cryotherapy, a procedure that freezes abnormal cervical tissue. This screen and treat approach is easy to teach and implement in low-resources settings, making it viable for scale-up nationwide.
In 2014, PATH implemented a train-the-trainer course with obstetricians and gynecologists in three townships in the Mandalay region. Through a training-of-trainers course and the provision of commodities (pelvic models and cryotherapy instruments), PATH led a training of trainers for obstetricians and gynecologists. These trained health staff then trained 40 Basic Health Staff in two districts of the project townships, designated by the Ministry of Health, to conduct the screenings.
By establishing services in two pilot districts, the regional and national governments now have an opportunity to evaluate the feasibility, acceptability, and affordability of a screen-and-treat approach based on VIA and cryotherapy. PATH is seeking additional funding to scale up this project and apply lessons learned and evidence generated from this approach to the development of national cervical cancer screening and treatment policy and guidelines.