Managing cervical cancer in Nepal: Need of consensual guideline
Keywords:Cervical intraepithelial neoplasia (CIN), colposcopy, Pap smear (Papanicolou stain), radical hysterectomy, visual inspection with acetic acid (VIA)
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 is
found grossly lacking and non existent outside major health institution. Only nominal data and intervention
efforts found published. There are three prongs of intervention level namely prevention/screening, treatment
and palliation together. Pap smear test is the standard screening tool wherever the cyto-diagnostic facility
exists. Visual Inspection with Acetic acid and Lugol's Iodine will be the feasible alternative at low resource
setting. Primary surgical treatment for early cervical cancer is the best option. Likewise chemo-radiation with
or without surgery will be the alternative option. Need of at least an operational guideline in each institution
is realized at this moment as a recommendation.
Key words: Cervical intraepithelial neoplasia (CIN); colposcopy; Pap smear (Papanicolou stain); radical
hysterectomy; visual inspection with acetic acid (VIA).
Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 3-10
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