Development and evaluation of a cervical cancer screening system in Cambodia

A collaborative project of the Cambodian Society of Gynecology and Obstetrics and Japan Society of Obstetrics and Gynecology

Yutaka Ueda, Kei Kawana, Nozomu Yanaihara, Kouji Banno, Maryan Chhit, Kyna Uy, Leangsim Kruy, Chan S. Sann, Miwa Ishioka-Kanda, Hiroki Akaba, Yasuyo Matsumoto, Noriko Fujita, Testu Yano, Kanal Koum, Aikou Okamoto, Tadashi Kimura

Research output: Contribution to journalArticle

Abstract

Aim: In Cambodia, the Japan Society of Obstetrics and Gynecology and the Cambodian Society of Gynecology and Obstetrics have an on-going project, started in 2015, for cervical cancer prevention and treatment. The project, currently aimed at factory workers, includes a women’s health education program that leads into cervical cancer prevention by establishment of a system for early detection and treatment. It begins by health education, screening for human papillomavirus (HPV), followed by colposcopy and quicker treatment of earlier precursor lesions. Methods: Rates for participant screening, HPV test positivity, cervical intraepithelial neoplasia (CIN) detection and distribution of HPV types were compared between two screening programs, factory-based and hospital-based. Some HPV test samples were divided into two, one of which was sent to Japan for a quality-control check of the Cambodian testing. Results: The factory-based participant screening rate was 19% (128/681). HPV was detected more frequently in the factory-based program participants (12%) than in the hospital-based program participants (5%). Unfortunately, however, the rate of receiving proper secondary colposcopy screening among the HPV-positive females was significantly higher in the hospital-based program (94%) than the factory-based program (40%) (P < 0.001). The Cambodian laboratory HPV testing accuracy was 92.6%. HPV types demonstrated no significant difference between the two prevention programs. Conclusion: We could successfully introduce HPV-based screening, starting from health education. However, low rate of screening, especially secondary screening for HPV positive factory workers was identified. Also, HPV testing could be further improved for accuracy through close monitoring.

Original languageEnglish
Pages (from-to)1260-1267
Number of pages8
JournalJournal of Obstetrics and Gynaecology Research
Volume45
Issue number7
DOIs
Publication statusPublished - 2019 Jul 1

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Cambodia
Gynecology
Early Detection of Cancer
Uterine Cervical Neoplasms
Obstetrics
Japan
Health Education
Colposcopy
Cervical Intraepithelial Neoplasia
Women's Health
Quality Control

Keywords

  • Cambodia
  • cervical cancer screening
  • human papillomavirus test
  • low-resource country
  • polymerase chain reaction
  • probe-hybridization

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Development and evaluation of a cervical cancer screening system in Cambodia : A collaborative project of the Cambodian Society of Gynecology and Obstetrics and Japan Society of Obstetrics and Gynecology. / Ueda, Yutaka; Kawana, Kei; Yanaihara, Nozomu; Banno, Kouji; Chhit, Maryan; Uy, Kyna; Kruy, Leangsim; Sann, Chan S.; Ishioka-Kanda, Miwa; Akaba, Hiroki; Matsumoto, Yasuyo; Fujita, Noriko; Yano, Testu; Koum, Kanal; Okamoto, Aikou; Kimura, Tadashi.

In: Journal of Obstetrics and Gynaecology Research, Vol. 45, No. 7, 01.07.2019, p. 1260-1267.

Research output: Contribution to journalArticle

Ueda, Y, Kawana, K, Yanaihara, N, Banno, K, Chhit, M, Uy, K, Kruy, L, Sann, CS, Ishioka-Kanda, M, Akaba, H, Matsumoto, Y, Fujita, N, Yano, T, Koum, K, Okamoto, A & Kimura, T 2019, 'Development and evaluation of a cervical cancer screening system in Cambodia: A collaborative project of the Cambodian Society of Gynecology and Obstetrics and Japan Society of Obstetrics and Gynecology', Journal of Obstetrics and Gynaecology Research, vol. 45, no. 7, pp. 1260-1267. https://doi.org/10.1111/jog.13968
Ueda, Yutaka ; Kawana, Kei ; Yanaihara, Nozomu ; Banno, Kouji ; Chhit, Maryan ; Uy, Kyna ; Kruy, Leangsim ; Sann, Chan S. ; Ishioka-Kanda, Miwa ; Akaba, Hiroki ; Matsumoto, Yasuyo ; Fujita, Noriko ; Yano, Testu ; Koum, Kanal ; Okamoto, Aikou ; Kimura, Tadashi. / Development and evaluation of a cervical cancer screening system in Cambodia : A collaborative project of the Cambodian Society of Gynecology and Obstetrics and Japan Society of Obstetrics and Gynecology. In: Journal of Obstetrics and Gynaecology Research. 2019 ; Vol. 45, No. 7. pp. 1260-1267.
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abstract = "Aim: In Cambodia, the Japan Society of Obstetrics and Gynecology and the Cambodian Society of Gynecology and Obstetrics have an on-going project, started in 2015, for cervical cancer prevention and treatment. The project, currently aimed at factory workers, includes a women’s health education program that leads into cervical cancer prevention by establishment of a system for early detection and treatment. It begins by health education, screening for human papillomavirus (HPV), followed by colposcopy and quicker treatment of earlier precursor lesions. Methods: Rates for participant screening, HPV test positivity, cervical intraepithelial neoplasia (CIN) detection and distribution of HPV types were compared between two screening programs, factory-based and hospital-based. Some HPV test samples were divided into two, one of which was sent to Japan for a quality-control check of the Cambodian testing. Results: The factory-based participant screening rate was 19{\%} (128/681). HPV was detected more frequently in the factory-based program participants (12{\%}) than in the hospital-based program participants (5{\%}). Unfortunately, however, the rate of receiving proper secondary colposcopy screening among the HPV-positive females was significantly higher in the hospital-based program (94{\%}) than the factory-based program (40{\%}) (P < 0.001). The Cambodian laboratory HPV testing accuracy was 92.6{\%}. HPV types demonstrated no significant difference between the two prevention programs. Conclusion: We could successfully introduce HPV-based screening, starting from health education. However, low rate of screening, especially secondary screening for HPV positive factory workers was identified. Also, HPV testing could be further improved for accuracy through close monitoring.",
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AU - Ueda, Yutaka

AU - Kawana, Kei

AU - Yanaihara, Nozomu

AU - Banno, Kouji

AU - Chhit, Maryan

AU - Uy, Kyna

AU - Kruy, Leangsim

AU - Sann, Chan S.

AU - Ishioka-Kanda, Miwa

AU - Akaba, Hiroki

AU - Matsumoto, Yasuyo

AU - Fujita, Noriko

AU - Yano, Testu

AU - Koum, Kanal

AU - Okamoto, Aikou

AU - Kimura, Tadashi

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N2 - Aim: In Cambodia, the Japan Society of Obstetrics and Gynecology and the Cambodian Society of Gynecology and Obstetrics have an on-going project, started in 2015, for cervical cancer prevention and treatment. The project, currently aimed at factory workers, includes a women’s health education program that leads into cervical cancer prevention by establishment of a system for early detection and treatment. It begins by health education, screening for human papillomavirus (HPV), followed by colposcopy and quicker treatment of earlier precursor lesions. Methods: Rates for participant screening, HPV test positivity, cervical intraepithelial neoplasia (CIN) detection and distribution of HPV types were compared between two screening programs, factory-based and hospital-based. Some HPV test samples were divided into two, one of which was sent to Japan for a quality-control check of the Cambodian testing. Results: The factory-based participant screening rate was 19% (128/681). HPV was detected more frequently in the factory-based program participants (12%) than in the hospital-based program participants (5%). Unfortunately, however, the rate of receiving proper secondary colposcopy screening among the HPV-positive females was significantly higher in the hospital-based program (94%) than the factory-based program (40%) (P < 0.001). The Cambodian laboratory HPV testing accuracy was 92.6%. HPV types demonstrated no significant difference between the two prevention programs. Conclusion: We could successfully introduce HPV-based screening, starting from health education. However, low rate of screening, especially secondary screening for HPV positive factory workers was identified. Also, HPV testing could be further improved for accuracy through close monitoring.

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