Adapting cervical dysplasia screening, treatment and prevention approaches to low resource settings.

ABSTRACT

Cervical cancer is a common disorder worldwide. Screening and treatment paradigms in highly developed countries have dramatically decreased disease prevalence and the implementation of preventive vaccination against high risk human papillomavirus (HPV) subtypes should decrease prevalence even further. Promising advances are also being made toward the development of a therapeutic vaccine for cervical neoplasia. Underresourced countries suffer from an inability to implement many of the approaches to prevention and diagnosis that have proved successful in countries with adequate resources. Several protocols are presently being developed that are low cost and require minimal training and infrastructure that may allow low-resource areas to begin to improve the early diagnosis of low and moderate grade cervical neoplasia. These protocols should support efforts at early treatment to prevent progression to cancer. Simultaneous expansion of prophylactic and possibly therapeutic vaccine availability is essential in the worldwide fight against this prevalent but largely preventable disease.