2Minireview Cervical Cancer Prevention in Low- and Middle-Income Countries: Feasible, Affordable, Essential

The annual worldwide burden of the preventable disease cervical cancer is over 530,000 new cases and 275,000 deaths, with the majority occurring in lowand middle-income countries (LMICs), where cervical cancer screening and early treatment are uncommon. Widely used in high-income countries, Pap smear (cytology-based) screening is expensive and challenging for implementation in LMICs, where lower-cost, effective alternatives such as visual inspection with acetic acid (VIA) and rapid human papillomavirus (HPV)-based screening tests offer promise for scaling up prevention services. Integrating HPV screening with VIA in “screen-and-treat-orrefer”’ programs offers the dual benefits of HPV screening to maximize detection and using VIA to triage for advanced lesions/cancer, as well as a pelvic exam to address other gynecologic issues. A major issue in LMICs is co-infection with human immunodeficiency virus (HIV) and HPV, which further increases the risk for cervical cancer and marks a population with perhaps the greatest need of cervical cancer prevention. Public-private partnerships to enhance the availability of cervical cancer prevention services within HIV/AIDS care delivery platforms through initiatives such as Pink Ribbon Red Ribbon® present an historic opportunity to expand cervical cancer screening in LMICs. Cancer Research. on April 8, 2017. © 2011 American Association for cancerpreventionresearch.aacrjournals.org Downloaded from Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Author Manuscript Published OnlineFirst on December 12, 2011; DOI: 10.1158/1940-6207.CAPR-11-0540