Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.

Cervical cancer is one of the most frequently occurring cancers among women in sub-Saharan Africa (SSA). While preventable if detected early, many women experience challenges accessing life-saving screening and treatment due to health systems inefficiencies, costs, perceptions of screening, and time required to seek care. Integration of cervical cancer screening into existing public health programs, such as screening women as they enter the health system for HIV treatment or bring their children to obtain routine immunizations, may increase screening coverage rates at low marginal costs. This dissertation aimed to evaluate the potential costs, cost-effectiveness, and budget impact of integrating cervical cancer screening into a routine childhood immunization clinic in Uganda and an HIV-treatment facility in Kenya. First, using primary facility-level data, a model-based analysis was conducted to estimate the individual level-costs of treatment for pre-cancerous lesions, cervical cancer, and cervical cancer palliative care in Kenya. Second, a Markov model was developed to assess the potential costeffectiveness of integrating screening programs into an HIV treatment clinic in Kenya and a routine childhood immunization clinic in Uganda. Third, a budget impact model estimated the size of the target population and potential uptake of screening, as well as the impact on the current health system, of each integration strategy. Study findings indicate that integrating cervical cancer screening into existing health systems in East Africa is likely to be cost-saving or cost-effective in terms of cost-per life year saved, compared to current strategies of nonintegrated screening. These findings provide decision-makers in Kenya, Uganda, and other similar LMICs with information on the costs and cost-effectiveness of innovative methods for increasing access to life-saving cervical cancer screening and treatment interventions.

Cancer is low or absent on the health agendas of low- and middle-income countries (LMCs) despite the fact that more people die from cancer in these countries than from AIDS and malaria combined. International health organizations, bilateral aid agencies, and major foundations—which are instrumental in setting health priorities—also have largely ignored cancer in these countries. This book identifies feasible, affordable steps for LMCs and their international partners to begin to reduce the cancer burden for current and future generations. Stemming the growth of cigarette smoking tops the list to prevent cancer and all the other major chronic diseases. Other priorities include infant vaccination against the hepatitis B virus to prevent liver cancers and vaccination to prevent cervical cancer. Developing and increasing capacity for cancer screening and treatment of highly curable cancers (including most childhood malignancies) can be accomplished using "resource-level appropriateness" as a guide. And there are ways to make inexpensive oral morphine available to ease the pain of the many who will still die from cancer.

World Cancer Report: Cancer Research for Cancer Prevention is a multidisciplinary publication, with leading international scientists as authors and reviewers. More than 60 different chapters describe multiple aspects of cancer prevention and the research that underpins prevention, focusing on research activity during the past 5 years. Starting with the latest trends in cancer incidence and mortality worldwide, this publication provides wide-ranging insights into cancer prevention based on the known causes of cancer, factors that determine how cancer develops, and the behaviour of different tumour types, and presents a broad scope of interventions to reduce the cancer burden from a global perspective, including addressing inequalities that affect cancer prevention.

This book presents analysis of data collected from patients of a safety-net healthcare system in Fort Worth, Texas. It examined three objectives, including explaining the utilization of Pap smear tests among the low-income women, by ascertaining the determinants of using these services. The existence of a race/ethnicity/immigration status effect was found. Anglos were more likely to have had a Pap smear, followed by African Americans, Hispanic immigrants and finally by, Hispanic Americans. The persistence of the race/ethnicity/immigration status effect may be explained by several factors, including cultural differences between the different groups studied. The race/ethnicity/immigration status effect on Pap smear screening changed with the introduction of age, usual source of care, check-up for current pregnancy, and having multiple competing needs for food, clothing and housing into the models studied. The findings may be attributed to the use of a hospital-based sample who had regular access to subsidized health insurance from a publicly funded safety-net healthcare network system. Publicly funded health programs for underserved populations should be maintained and strengthened.