Treatment Outcomes and Follow-Up after Management of VIA-Detected Cervical Lesions in Bangladesh
Keywords:
cervical cancer, VIA, treatment outcome, follow-up, LEEP, thermocoagulation, cold coagulationAbstract
Background: Cervical cancer prevention depends on completion of treatment and appropriate post-treatment surveillance. Objective: To describe treatment distribution, follow-up attendance and clinical/colposcopic outcomes after management of VIA-detected cervical lesions. Methods: Follow-up data were derived from the BSMMU colposcopy clinic component of a cross-sectional thesis conducted from July 2017 to June 2018. Of 132 women documented as receiving specific local treatment, 55 subsequently attended documented follow-up. Results: Among the 132 treated women, LEEP accounted for 59.1%, thermocoagulation 15.1%, cold coagulation 15.1% and cauterization 10.6%. Among 55 women who returned for follow-up, 30 (54.5%) had undergone LEEP, 10 (18.2%) cold coagulation, 10 (18.2%) cauterization and 5 (9.1%) thermocoagulation. Forty-five (81.8%) were classified as improved/case negative, 7 (12.7%) as case positive and 3 (5.4%) as suspected cases. More than half attended one follow-up visit, 36.4% attended twice and 9.1% attended three or more times. Conclusion: Most women who returned for follow-up were classified as improved, but the follow-up cohort represented less than half of the documented specific-treatment group. The observed 81.8% improvement should therefore not be interpreted as a cure rate for the entire treated cohort. Strengthening recall and tracking systems is essential.
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