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Vet, J.N.I. (2023)

Screening in low resource settings, towards a world without cervical cancer

Doctoral Thesis
Cervical cancer is a major public health problem, especially in developing countries where the health care infrastructure often prohibits successful implementation of organized screening programs due to lack of financial support, professional human resources, and laboratory services. Indonesia is a developing country with high rates of cervical cancer, with limited organized screening programs especially in low resource settings.
In this thesis several aspects of cervical cancer in Indonesia have been studied; starting with a description of the prevalent HPV types in Indonesia in a hospital based population and in a population based setting (chapter 2 and 3). An alternative way of cervical cancer screening in a single visit approach has been set up in low resource areas in Indonesia and is described in chapter 4: “See and Treat” using visual inspection with 3-5% acetic acid (VIA) and treatment with cryotherapy. Furthermore, we investigated the HPV types persisting after...Show moreCervical cancer is a major public health problem, especially in developing countries where the health care infrastructure often prohibits successful implementation of organized screening programs due to lack of financial support, professional human resources, and laboratory services. Indonesia is a developing country with high rates of cervical cancer, with limited organized screening programs especially in low resource settings.
In this thesis several aspects of cervical cancer in Indonesia have been studied; starting with a description of the prevalent HPV types in Indonesia in a hospital based population and in a population based setting (chapter 2 and 3). An alternative way of cervical cancer screening in a single visit approach has been set up in low resource areas in Indonesia and is described in chapter 4: “See and Treat” using visual inspection with 3-5% acetic acid (VIA) and treatment with cryotherapy. Furthermore, we investigated the HPV types persisting after cryotherapy (chapter 5). In the last chapter we assessed the performance of an objective tool for cervical cancer screening; screening with an optoelectronic device (chapter 6).
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Cervical cancer screening
Visual inspection with acetic acid (VIA)
Cryotherapy
Human Papillomavirus
See and Treat
Low- and Middle- income countries
All authors
Vet, J.N.I.
Supervisor
Fleuren, G.J.; Trimbos, J.B.M.Z.
Co-supervisor
Boer, M.A. de
Committee
Lith, J.M.M. van; Hacker, N.F.; Mourits, M.J.E.; Smit, V.T.H.B.M.; Beltman, J.J.
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2023-11-15
ISBN (print)
9789464911602

Funding

Sponsorship
Female Cancer Foundation (www⁠.femalecancerfoundation.org)