Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices

Table 1 Obstacles to cervical cancer screening in low- and middle-income countries

Practical/logistical reasons

Widespread poverty

Lack of healthcare infrastructure

Absence of sustained prevention programmes

Lack of trained practitioners

Lack of laboratory supplies

Lack of patient management guidelines

Limited physical access of the population

Knowledge, religion and beliefs

Lack of knowledge of cervical cancer

Limited access of the population to information

Women disempowerment

Socio-religious and cultural barriers to routine pelvic screening

Political

Lack of support from the Ministery of Health

Competing healthcare priorities

War and civil strife

Others

High temperatures in tropical countries with lack of proper climatisation

Particularities about the screening test

VIA

Significant number of unnecessary and unsustainable treatment

Cytology

Need important health-care resource and infrastructure

Need important laboratory supplies

Screening requires more than one visit (important drop out)

Further testing with colposcopy wouldn't be possible, leading to unnecessary agressive and unsustainable treatment

HPV

Need important healthcare infrastructure

Need important laboratory supplies

VIA: Visual inspection tests with 3%-5% acetic acid; HPV: Human papillomavirus.