Women's Global Health Initiative: Prevention of Cervical Cancer Using Visual Inspection with Acetic Acid and Cryotherapy

Cervical cancer is the most common type of cancer in women between 15 and 44 years of age in Nicaragua (ICO Information Centre, 2014), yielding one of the highest cervical cancer rates in Latin America, and the incidence is on the rise (Soneji & Fukui, 2013). The ICO Information Centre on HPV and Cancer (2014) estimates that 934 women are diagnosed with cervical cancer annually in Nicaragua, resulting in 424 deaths. In an effort to reduce the cervical cancer risk in this region, a partnership has been formed with a health sciences center in the United States, the Nicaraguan Ministry of Health, and a non-governmental organization to establish a women’s health program to promote early diagnosis and treatment of cervical dysplasia. A framework for this effort was fashioned after similar programs implemented in regions of Africa and Guatemala (World Health Organization, 2012), and the program is enhanced by the interprofessional focus of the partnership, which includes faculty and students from the schools of allied health, medicine, nursing, and pharmacy. The plan involves training health care workers in the Jinotega region, with a combined rural and urban population of approximately 500,000, to perform visual inspection of the cervix using acetic acid (VIA) and treatment with cryotherapy if indicated. Faculty and students from the health sciences center traveled to Jinotega in January 2014 to begin the first phase of the program and to conduct the first VIA clinics. Three goals of the women’s health initiative include developing a sustainable regional program to (a) create awareness in the Nicaragua region about prevention of cervical cancer, (b) screen women in the region using VIA, and (c) treat patients with a positive test using cryotherapy or refer patients for further evaluation if not eligible for cryotherapy.  The women’s health initiative in Nicaragua has grown, resulting in six to seven annual trips to Jinotega.  Faculty are also exploring the possibilities of replicating the program in other low resource countries.