WHO guidelines for the use of thermal ablation for cervical pre-cancer lesions - WHO:
WHO's riktlinjer för behandling av livmoderhalscancer, 2019.
It is estimated that more than 311 000 women die of cervical cancer each year. Of these deaths, 91% occur in low- and middle-income countries. Demographic changes and a lack of action mean that the number of deaths per year is projected to reach 460 000 by 2040.
Screening programmes have dramatically reduced cervical cancer rates in high-income countries. Screening using a cytology-based method and histological confirmation of cervical intraepithelial neoplasia (CIN) is typically followed by treatment such as cryotherapy, large loop excision of the transformation zone (LLETZ), and cold knife conization (CKC).
However, in low- and middle-income countries, it has not been possible to obtain high population coverage with cytology-based screening, and other tests are being used to screen, including visual inspection with acetic acid (VIA) and more recently, DNA/RNA tests for human papillomavirus (HPV). Screen-and-treat algorithms, where women who are positive for a screening test are treated with ablative treatment (destruction of the cervical transformation zone including the lesion), have been implemented.