Well woman clinic concept: An integrated approach for screening and early diagnosis of breast and gynecological cancers in developing countries

Abstract

A vertical delivery of an integrated healthcare intervention to decrease mortality from breast and gynecological cancers is proposed for implementation through a Well Woman Clinic. The operations and logistics of such a clinic are discussed in this chapter. The pros and cons of horizontal and vertical delivery of healthcare services and the bene fi ts of an integrated approach to screen for cancers in women are outlined. The methodology proposed is to screen for breast and cervical cancer and to diagnostically test symptomatic postmenopausal woman so as to detect endometrial and ovarian cancers at an early stage. The healthcare personnel required to carry out these tasks and the training and telemedicine support to ensure quality and consistency of services provided also are discussed. The need to have a robust and enforced referral system in place to provide a continuum of care for those women who are tested positive for malignancy and need definitive treatment and or surgery is emphasized. The methodology may need modifications for adaptation to individual countries and resources available; the core principle, however, of this proposal is integration of a well woman exam with screening and early diagnosis of multiple commonly occurring cancers affecting women. Some variation in the screening methodology, particularly for cervical cancer, is expected from one country to another and will be in fl uenced by factors such as existing national or professional body guidelines or resource limitations.