Cervical cancer library

Screening and treatment

Featured resources

10 Key Findings and Recommendations for Effective Cervical Cancer Screening and Treatment Programs
Alliance for Cervical Cancer Prevention (ACCP)
In early 2007, the ACCP partners met to assess newly-analyzed results of key studies in India, South Africa, Peru, and Thailand. These new data spurred the partners to outline ten key findings and recommendations for global policy and practice related to cervical cancer screening and treatment in low-resource settings.

Cervical cancer page
International Agency for Research on Cancer (IARC)
This page features numerous training and research resources that explore the accuracy, reproducibility, efficacy, benefits, harmful effects, and cost-effectiveness of screenings interventions for cervical cancer.

Cervical Cancer Prevention in Peru: Lessons Learned from the TATI Demonstration Project (2006)
Luciani S, Winkler J
Through collaboration of the Peru Ministry of Health, Pan American Health Organization, and PATH, the TATI (acronym for the Spanish term, tamizaje y tratamiento inmediato) demonstration project investigated methods that could improve the effectiveness of the cervical cancer screening program in the region of San Martín, Peru. This report summarizes the methods, results, and lessons learned from the TATI project.

Colposcopy and Treatment of Cervical Intraepithelial Neoplasia: A Beginner’s Manual (2003)
Sellors J, Sankaranarayanan R, IARC.
This online manual is designed to equip health care providers with the necessary skills to detect and treat cervical intraepithelial neoplasia, thereby preventing invasive cervical cancer in many women worldwide.

Comprehensive Cervical Cancer Control: A guide to essential practice (2014)
World Health Organization (WHO)
This publication is designed to provide comprehensive practical advice to health care providers at all levels of the health care system on how to prevent, detect early, treat and palliate cervical cancer.

Course in Visual Methods for Cervical Cancer Screening: Visual Inspection with Acetic Acid and Lugol's Iodine (2004)
PATH
This manual is designed for trainers of clinicians who perform vaginal speculum
examination and screening methods to prevent cervical cancer. The online version below is a preview—the complete CD-ROM may be ordered by emailing rho@path.org.

Update: Since this CD-ROM was produced in 2004, PATH no longer recommends the use of Lugol's iodine for visual inspection.

Cryotherapy Market Dynamics: Assessment and Recommendations (2015)
PATH
Through the Cryotherapy Market Dynamics Project, PATH undertook an analysis of supply-and-demand factors to determine whether there are market interventions that could ameliorate the current low levels of treatment coverage.

Developing role of HPV in cervical cancer prevention (2013)
Kitchener HC, Denton K, Soldan K, Crosbie EJ. BMJ. 2013;347:f4781.
Vaccination has the potential to prevent deaths worldwide over the next 50 years, but requires the political will and determination to tackle what is now among the most common killers of women in impoverished countries.

Evidence-Based, Alternative Cervical Cancer Screening Approaches in Low-Resource Settings (2009)
Sherris J, Wittet S, Kleine A, et al. International Perspectives on Sexual and Reproductive Health. 2009;35(3)147-152.
On the basis of new data and the results of earlier research conducted in 20 African, Asian and Latin American countries, the ACCP partners summarize and share key findings and recommendations for effective cervical cancer screening and treatment programs in low-resource settings in this 6-page article.

Expanding paradigms for cervical cancer screening: The impact of the Alliance for Cervical Cancer Prevention (2013)
ACCP
This paper documents the accomplishments of the ACCP. To put the contributions of ACCP and its partners in perspective, the report also presents the state of knowledge about alternative screening strategies prior to the establishment of the partnership, as well as contributions of non-ACCP–affiliated researchers to the field.

Global Guidance for Cervical Cancer Prevention and Control (2009)
International Federation of Gynecology and Obstetrics (FIGO)
This guidance is intended as a focused update on cervical cancer prevention, screening and treatment strategies. It is intended to be complimentary to the World Health Organization's Comprehensive Cervical Cancer Control: A Guide to Essential Practice.

Histopathology of the uterine cervix - digital atlas (2003)
Frappart L, Fontanière B, Lucas E, Sankaranarayanan R. IARC.
This atlas is intended for practicing pathologists, cytotechnologists and technicians. It is also suitable for resident pathologists training in medical schools and for cytology technicians, particularly in developing countries.

HPV Tests for Cervical Cancer Screening (2016)
Pan American Health Organization
There are several HPV testing products available. To aid decision-making by cervical cancer program managers in selecting an HPV test for use in their programs, these charts provide information on the main HPV tests available, along with their characteristics.

Improved Cervical Cancer Prevention: Planning Now for a Better Future (2010)
PATH, Association of Obstetricians and Gynaecologists of Uganda, Uganda Ministry of Health
This report documents an African regional conference on cervical cancer prevention held in September 2010 in Kampala, Uganda. Representatives from nine African countries met to share updates on cervical cancer vaccination and screening programs, and to plan regional strategies. Participants were from the fields of cancer, reproductive health, immunization, adolescent health and related areas. The report summarizes conference presentations and country discussions on priorities, activities, and needs for technical support.

Improving Screening Coverage Rates of Cervical Cancer Prevention Programs: A Focus on Communities (2004)
Cervical Cancer Prevention Issues in Depth No. 4. ACCP.
This paper describes the community focus taken by ACCP projects in eight countries. Included is an overview of the strategies used to increase screening coverage, and lessons learned about how to meet women’s needs effectively through a community focus.

Integrating HPV testing in cervical cancer screening programs: A manual for program managers (2016)
Pan-American Health Organization and US Centers for Disease Control and Prevention
This guide provides up-to-date information on HPV testing, to facilitate strengthening cervical cancer screening programs.

Glossary of Screening, Diagnosis and Treatment Methods for Cervical Cancer (2004)
Pan American Health Organization (PAHO)
This 4-page document is a glossary of terms specific to screening, stages of cancer, and advanced treatment.

Management of cervical cancer: strategies for limited-resource centres—a guide for radiation oncologists (2013)
International Atomic Energy Agency
This publication is written for radiation oncologists working in centers with limited resources and treating a large number of patients with cervical cancer. The approach and techniques are intended to be simple, feasible, and resource sparing.

Monitoring national cervical cancer prevention and control programmes: quality control and quality assurance for visual inspection with acetic acid (VIA)-based programmes (2013)
World Health Organization and PAHO
This guide outlines quality control and quality assurance considerations to support introduction or scale-up of visual inspection with acetic acid as a screening test for cervical cancer within the context of national comprehensive cervical cancer prevention and control programs. It is intended primarily for programme managers, supervisors and other stakeholders working in public health programs for cervical cancer prevention and control.

A Multicountry Evaluation of careHPV Testing, Visual Inspection With Acetic Acid, and Papanicolaou Testing for the Detection of Cervical Cancer (2014)
Jeronimo J, Bansil P, Lim J, et al. International Journal of Gynecological Cancer. 2014;24(3), 576–585.
This study evaluated the feasibility and performance of careHPV, a novel human papillomavirus (HPV) DNA test, when used for screening women for cervical cancer in low-resource settings.

New evidence on the impact of cervical cancer screening and treatment using HPV DNA tests, visual inspection, or cytology (2009)
ACCP
This 3-page fact sheet puts evidence from India into context and provides guidance relating to investment in visual inspection-based screening programs in low-resource settings. The document seeks to help program managers and decision-makers interpret and use the new data.

New Molecular Cervical Cancer Screening Technologies: Results from PATH's START-UP Project
PATH
This brief describes two HPV screening methods developed and tested by PATH for low-resource settings: the careHPV™ DNA test and the OncoE6™ cervical test.

New Options for Cervical Cancer Screening and Treatment in Low-Resource Settings (2010)
Cervical Cancer Action
Examines screening in the era of HPV vaccination and provides the latest evidence on new screening and treatment modalities for developing countries.

Outlook. Progress in preventing cervical cancer: Updated evidence on vaccination and screening
Murray M. Outlook. 2010;27(2). PATH.
This 12-page issue of Outlook provides an update on opportunities for preventing cervical cancer through vaccination and screening. It summarizes recent evidence on the safety and efficacy of human papillomavirus vaccines as well as successful approaches for screening and treatment in low-resource areas. Other topics include cost-effectiveness, communication and training, and implications for policy and programs.

Preventing cervical cancer through better guidelines in Guatemala (2015)
PATH
This 4-page document is intended to help advocates assess policy/advocacy options, plan goals and activities, and develop a strategy for impact. Advocates worked with the Guatemalan government to create policy guidelines that incorporate new cervical cancer screening technologies, bring the country's recommendations in line with current WHO guidance, and promise to save Guatemalan women's lives from this preventable disease.

Planning and Implementing Cervical Cancer Prevention and Control Programs: A Manual for Managers (2004)
PATH and ACCP
This publication provides thorough background information on cervical cancer and extensive detail on screening.

A Practical Manual on Visual Screening for Cervical Neoplasia (2003)
Sankaranarayanan R and Wesley R, eds. IARC.
Featuring 80 color photographs, this 49-page manual is intended to help in the training of a range of health-care personnel such as health workers, nurses and physicians to perform visual inspection with acetic acid and visual inspection with Lugol's iodine. Information on ordering printed copies is also available.

PubMed article search: Cervical cancer screening and treatment
National Center for Biotechnology Information (National Library of Medicine and National Institutes of Health)
This predefined search on cervical cancer and HPV screening and treatment contains the latest scientific journal citations and abstracts from the PubMed database.

Recent Evidence on Cervical Cancer Screening in Low-Resource Settings (2011)
ACCP
This fact sheet summarizes recent data on cervical cancer screening approaches for low-resource settings. This summary presents evidence published since ACCP's 2009 article on alternative screening approaches. New evidence continues to support the feasibility and accuracy of screening technologies that are alternatives to resource-intensive Pap smears.

Saving the World's Women from Cervical Cancer (2016)
Tsu V, Jerónimo J. New England Journal of Medicine. 2016;374:2509–2511.
From the article: ...By focusing on implementing sustainable, population-based screening on a national scale, rather than establishing limited pilot efforts based on unrealistic strategies and unsuitable technology such as Pap smears, we believe that LMICs can change the current pattern, leapfrog old technologies, ensure equitable access for rural and poor women, and reduce related mortality by half. Countries that can afford to do more than implement this basic approach, such as screening more than once or screening older women, can expect even greater disease reduction.

Scale-Up project fact sheet (2015)
PATH
The PATH Scale-Up project seeks to reduce cervical cancer incidence through improved and expanded screening using HPV testing.

Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Clinical Practice Guideline (2016)
American Society of Clinical Oncology (ASCO)
ASCO convened a multidisciplinary, multinational panel of oncology, primary care, epidemiology, health economic, cancer control, public health, and patient advocacy experts to produce recommendations reflecting four resource-tiered settings. A review of existing guidelines, a formal consensus-based process, and a modified ADAPTE process to adapt existing guidelines were conducted. Other experts participated in formal consensus.

Western Kenya Cervical Cancer Prevention Project Final Report (2004)
ACCP
This 35-page report is from a collaborative project with PATH, the Kenya Ministry of Health, Mandeleo ya Wanawake Organization, and the Kenya Cancer Society to develop and evaluate a model cervical cancer prevention program suitable for rural, low-resource settings in Africa. Appendices are available by contacting rho@path.org.

WHO guidelines: Use of cryotherapy for cervical intraepithelial neoplasia (2011)
WHO
This document summarizes the new evidence-based WHO recommendations about the use of cryotherapy in women with histologically confirmed cervical intraepithelial neoplasia in low-, middle- and high-income countries.

WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention (2013)
WHO
This guideline provides recommendations for cervical cancer screen-and-treat program strategies. The publication is intended primarily for policymakers, managers, program officers, and other professionals in the health sector who have responsibility for choosing strategies for cervical cancer prevention, at country, regional and district levels.

WHO technical specifications: Cryosurgical equipment for the treatment of precancerous cervical lesions and prevention of cervical cancer (2012)
WHO
This document seeks to assist program managers, purchasing managers, and other interested parties with the procurement, management and effective use of cryosurgical equipment to treat precancerous cervical lesions as part of a comprehensive cervical cancer prevention program.

Institut Català d'Oncologia Information Centre on HPV and Cancer
Institut Català d'Oncologia
This website offers country-specific reports on cervical cancer burden of disease, prevalence of HPV infections, and related factors for cervical disease to evaluate prevention strategies.

WHO HPV Laboratory Network (LabNet)
WHO
LabNet's mission is to contribute to improving quality of laboratory services for effective surveillance and monitoring of HPV vaccination impact through enhanced, state-of-the-art laboratory support.

General screening and treatment resources

Cervical Cancer: Prevention and Early Detection page
American Cancer Society
This page provides complete information about cervical cancer screening, treatment, risk factors, and prevention.

Cervical cancer prevention: safety, acceptability, and feasibility of a single-visit approach in Accra, Ghana.
Blumenthal PD, Gaffikin L, Deganus S, et al. American Journal of Obstetrics and Gynecology. 2007;196(4):407.e1–407.e9.
This study assessed the safety and acceptability of a single-visit approach to cervical cancer prevention combining visual inspection of the cervix with acetic acid wash (VIA) and cryotherapy.

Cervical cancer screening and testing page
National Cancer Institute
Developed for both patients and health professionals, this page provides extensive information about tests used to screen for cervical cancer, as well as how to interpret test results.

Guidelines for cervical cancer screening programme (2005)
Government of India-WHO Collaborative Programme
These guidelines have been developed for population-based cervical cancer screening programmes in India, and can be adapted according to available resources.

Jhpiego technical reports from Ghana and Thailand (2008)
Jhpiego
These operations research studies examined the extent to which the quality of cervical cancer prevention and treatment services was maintained after external funding had been removed in Ghana and Thailand—two countries with Cervical Cancer Prevention (CECAP) programs that had previously
received significant external financial support.

Medline Plus: Cervical cancer
National Library of Medicine and National Institutes of Health
Medline Plus provides listings of cervical cancer resources in the areas of prevention, screening, treatment, and research. The site also includes information about cervical cancer organizations, law, policy, and more. Resources are US-focused, but could be adapted for global contexts.

OncoLink: Cervical cancer
Abramson Cancer Center of the University of Pennsylvania
OncoLink offers a range of information, including an overview of cervical cancer, summaries of recent US meetings on cancer, and examples of provider and client information on Papanicolau (Pap) tests, colposcopy, and dysplasia treatment. The site is intended for a US audience, but much of the information (in particular the client-oriented material) could be adapted for use in other settings.