TY - JOUR
T1 - Expanding Cervical Cancer Screening in Mozambique
T2 - Challenges Associated With Diagnosing and Treating Cervical Cancer
AU - Batman, Samantha
AU - Rangeiro, Ricardina
AU - Monteiro, Eliane
AU - Changule, Dercia
AU - Daud, Siro
AU - Ribeiro, Magda
AU - Tsambe, Edgar
AU - Bila, Celso
AU - Osman, Nafissa
AU - Carrilho, Carla
AU - Neves, Andrea
AU - Atif, Hira
AU - De Jesus, Celda
AU - Mariano, Arlete
AU - Moretti-Marques, Renato
AU - Vieira, Marcelo
AU - Fontes-Cintra, Georgia
AU - Lopes, Andre
AU - Batware, Jean Claude
AU - Luis, Elvira
AU - Grover, Surbhi
AU - Baker, Ellen
AU - Fellman, Bryan
AU - Montealegre, Jane
AU - Castle, Philip E.
AU - Jeronimo, Jose
AU - Chiao, Elizabeth
AU - Lorenzoni, Cesaltina
AU - Schmeler, Kathleen
AU - Salcedo, Mila P.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - PURPOSE: Mozambique has one of the highest burdens of cervical cancer globally. Treatment options are few as most women present with advanced disease, and there are limited trained health professionals and health care resources. The objective of this study was to describe the outcomes of women diagnosed with invasive cancer as part of the Mozambican women undergoing cervical cancer screening with human papillomavirus (HPV) testing in conjunction with family planning services (MULHER) study. MATERIALS AND METHODS: Women age 30-49 years were prospectively enrolled in the MULHER study and offered screening with primary HPV testing followed by treatment of screen-positive women with thermal ablation or excision as appropriate. Women with cervical examination findings suspicious for cancer were referred to one of the three gynecologic oncologists in the country. RESULTS: Between January 2020 and January 2023, 9,014 women underwent cervical cancer screening and 30 women were diagnosed with cervical cancer. In this cohort, four patients (13.3%) had early-stage disease, 18 (60.0%) had locally advanced disease, one (3.3%) had distant metastatic disease, and seven (23.3%) did not have staging information available. Five patients (16.6%) died without receiving oncologic treatment, and seven patients (23.3%) are still awaiting treatment. Of the remaining 18 patients, three (17.6%) underwent surgery and four (23.5%) received radiotherapy. Eleven (36.7%) patients received only chemotherapy. CONCLUSION: As cervical screening programs are implemented in low-resource settings, there will likely be an increase in the number of women diagnosed with invasive cervical cancer. Our results in Mozambique demonstrate the need to increase access to advanced surgery, radiation, and palliative care services.
AB - PURPOSE: Mozambique has one of the highest burdens of cervical cancer globally. Treatment options are few as most women present with advanced disease, and there are limited trained health professionals and health care resources. The objective of this study was to describe the outcomes of women diagnosed with invasive cancer as part of the Mozambican women undergoing cervical cancer screening with human papillomavirus (HPV) testing in conjunction with family planning services (MULHER) study. MATERIALS AND METHODS: Women age 30-49 years were prospectively enrolled in the MULHER study and offered screening with primary HPV testing followed by treatment of screen-positive women with thermal ablation or excision as appropriate. Women with cervical examination findings suspicious for cancer were referred to one of the three gynecologic oncologists in the country. RESULTS: Between January 2020 and January 2023, 9,014 women underwent cervical cancer screening and 30 women were diagnosed with cervical cancer. In this cohort, four patients (13.3%) had early-stage disease, 18 (60.0%) had locally advanced disease, one (3.3%) had distant metastatic disease, and seven (23.3%) did not have staging information available. Five patients (16.6%) died without receiving oncologic treatment, and seven patients (23.3%) are still awaiting treatment. Of the remaining 18 patients, three (17.6%) underwent surgery and four (23.5%) received radiotherapy. Eleven (36.7%) patients received only chemotherapy. CONCLUSION: As cervical screening programs are implemented in low-resource settings, there will likely be an increase in the number of women diagnosed with invasive cervical cancer. Our results in Mozambique demonstrate the need to increase access to advanced surgery, radiation, and palliative care services.
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U2 - 10.1200/GO.23.00139
DO - 10.1200/GO.23.00139
M3 - Article
C2 - 37824802
AN - SCOPUS:85175584786
SN - 2378-9506
VL - 9
SP - e2300139
JO - JCO Global Oncology
JF - JCO Global Oncology
ER -