See and treat: Cervical cancer prevention strategy in Indonesia with VIA-DoVIA screening and prompt treatment

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Laila Nuranna


Cervical cancer, as the second most common type of cancer in Indonesia after breast cancer, is a major problem for Indonesian women. Cervical cancer can be prevented with HPV vaccination and various screening/early detection methods, such as Pap smear, VIA (visual inspection with acetic acid) test, and HPV-DNA test. Currently, VIA test is the chosen screening method for cervical cancer in Indonesia, as it is easy, cheap, accurate, and can be implemented in all regions of the country. The VIA method was developed using VIA documentation (DoVIA) and VIA documentation telemedicine (TeleDoVIA). It is established that positive findings should be treated with cryotherapy. This serial of diagnosis using VIA screening and treatment with cryotherapy is termed See and Treat. Subsequently, it is developed into Screen and Treat. The gas supply for cryotherapy may become a challenge, which drive the search for an alternative therapeutic method, such as using TCA (trichloroacetic acid). Strategies for the prevention of cervical cancer includes implementation of HPV vaccination (90%), 70% coverage of screening, and treatment after positive findings (90%). The involvement of the authorities is crucial for the achievement of strategical target and its public implementation, by setting regulations for the success of screening coverage.

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Review Article