Managing cervical cancer in Nepal: Need of consensual guideline

Abstract

The purpose of this review is to bridge the pattern of intervention in optimal and sub-optimal facility level.Several guidelines for the screening and treatment of cervical cancer are reviewed. Routine screening isfound grossly lacking and non existent outside major health institution. Only nominal data and interventionefforts found published. There are three prongs of intervention level namely prevention/screening, treatmentand palliation together. Pap smear test is the standard screening tool wherever the cyto-diagnostic facilityexists. Visual Inspection with Acetic acid and Lugol's Iodine will be the feasible alternative at low resourcesetting. Primary surgical treatment for early cervical cancer is the best option. Likewise chemo-radiation withor without surgery will be the alternative option. Need of at least an operational guideline in each institutionis realized at this moment as a recommendation.Key words: Cervical intraepithelial neoplasia (CIN); colposcopy; Pap smear (Papanicolou stain); radicalhysterectomy; visual inspection with acetic acid (VIA).DOI: 10.3126/njog.v4i1.3324Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 3-10