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The Development of Locoregional Therapies as a Strategy for Reducing Cervical Cancer Mortality in Low to Middle Income Countries.
  • Tsitsi Chituku,
  • Susan Jones,
  • Roger Phillips
Tsitsi Chituku
Pilgrim Hospital

Corresponding Author:tgchituku@doctors.org.uk

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Susan Jones
York St John University
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Roger Phillips
University of Huddersfield School of Applied Sciences
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Early detection concomitant with appropriate treatment intervention for pre-invasive cervical cancer has proved effective in the ‘war on cervical cancer’ in the developed world. Unfortunately, these advances have not been mirrored in the developing world, where incidence and mortality rates are currently approximately 90% of the world’s burden. Due to economic, infrastructure and skilled personnel constraints, the impact of cytology screening as a method for early detection and reducing mortality rates from cervical cancer is lower. Typically, women present with advanced disease that is difficult to treat because of de novo and pharmacokinetic resistance. Whilst the HPV vaccine is a welcome development in the fight against cervical cancer, for women who are outside the target age of vaccination, or indeed do not have access to vaccination, screening remains the only form of protection. Current excisional treatments available for cervical dysplasia are effective but have limitations, including increased incidence of obstetric complications and risk of recurrence. This is a particular issue in cases of HIV, which is endemic in the regions most affected by cervical cancer. Therefore, early detection combined with early treatment is an attractive strategy to reduce the number of women presenting with drug resistant disease in developing countries where cytology screening and vaccination services are poorly developed. This review makes the case for developing a locoregional treatment therapy for cervical dysplasia which could be incorporated into a cervical cancer screening strategy in a rural setting within a developing country.