PROBLEM: Although it is highly preventable and treatable, cervical cancer is the most common and most deadly cancer among women in Rwanda. APPROACH: By mobilizing a diverse coalition of partnerships, Rwanda became the first country in Africa to develop and implement a national strategic plan for cervical cancer prevention, screening and treatment. LOCAL SETTING: Rwanda - a small, landlocked nation in East Africa with a population of 10.4 million - is well positioned to tackle a number of "high-burden" noncommunicable diseases. The country's integrated response to infectious diseases has resulted in steep declines in premature mortality over the past decade. RELEVANT CHANGES: In 2011-2012, Rwanda vaccinated 227,246 girls with all three doses of the human papillomavirus (HPV) vaccine. Among eligible girls, three-dose coverage rates of 93.2% and 96.6% were achieved in 2011 and 2012, respectively. The country has also initiated nationwide screening and treatment programmes that are based on visual inspection of the cervix with acetic acid, testing for HPV DNA, cryotherapy, the loop electrosurgical excision procedure and various advanced treatment options. LESSONS LEARNT: Low-income countries should begin to address cervical cancer by integrating prevention, screening and treatment into routine women's health services. This requires political will, cross-sectoral collaboration and planning, innovative partnerships and robust monitoring and evaluation. With external support and adequate planning, high nationwide coverage rates for HPV vaccination and screening for cervical cancer can be achieved within a few years.
PROBLEM: Although it is highly preventable and treatable, cervical cancer is the most common and most deadly cancer among women in Rwanda. APPROACH: By mobilizing a diverse coalition of partnerships, Rwanda became the first country in Africa to develop and implement a national strategic plan for cervical cancer prevention, screening and treatment. LOCAL SETTING: Rwanda - a small, landlocked nation in East Africa with a population of 10.4 million - is well positioned to tackle a number of "high-burden" noncommunicable diseases. The country's integrated response to infectious diseases has resulted in steep declines in premature mortality over the past decade. RELEVANT CHANGES: In 2011-2012, Rwanda vaccinated 227,246 girls with all three doses of the human papillomavirus (HPV) vaccine. Among eligible girls, three-dose coverage rates of 93.2% and 96.6% were achieved in 2011 and 2012, respectively. The country has also initiated nationwide screening and treatment programmes that are based on visual inspection of the cervix with acetic acid, testing for HPV DNA, cryotherapy, the loop electrosurgical excision procedure and various advanced treatment options. LESSONS LEARNT: Low-income countries should begin to address cervical cancer by integrating prevention, screening and treatment into routine women's health services. This requires political will, cross-sectoral collaboration and planning, innovative partnerships and robust monitoring and evaluation. With external support and adequate planning, high nationwide coverage rates for HPV vaccination and screening for cervical cancer can be achieved within a few years.
Authors: Agnes Binagwaho; Paul E Farmer; Sabin Nsanzimana; Corine Karema; Michel Gasana; Jean de Dieu Ngirabega; Fidele Ngabo; Claire M Wagner; Cameron T Nutt; Thierry Nyatanyi; Maurice Gatera; Yvonne Kayiteshonga; Cathy Mugeni; Placidie Mugwaneza; Joseph Shema; Parfait Uwaliraye; Erick Gaju; Marie Aimee Muhimpundu; Theophile Dushime; Florent Senyana; Jean Baptiste Mazarati; Celsa Muzayire Gaju; Lisine Tuyisenge; Vincent Mutabazi; Patrick Kyamanywa; Vincent Rusanganwa; Jean Pierre Nyemazi; Agathe Umutoni; Ida Kankindi; Christian Ntizimira; Hinda Ruton; Nathan Mugume; Denis Nkunda; Espérance Ndenga; Joel M Mubiligi; Jean Baptiste Kakoma; Etienne Karita; Claude Sekabaraga; Emmanuel Rusingiza; Michael L Rich; Joia S Mukherjee; Joseph Rhatigan; Corrado Cancedda; Didi Bertrand-Farmer; Gene Bukhman; Sara N Stulac; Neo M Tapela; Cassia van der Hoof Holstein; Lawrence N Shulman; Antoinette Habinshuti; Matthew H Bonds; Michael S Wilkes; Chunling Lu; Mary C Smith-Fawzi; JaBaris D Swain; Michael P Murphy; Alan Ricks; Vanessa B Kerry; Barbara P Bush; Richard W Siegler; Cori S Stern; Anne Sliney; Tej Nuthulaganti; Injonge Karangwa; Elisabetta Pegurri; Ophelia Dahl; Peter C Drobac Journal: Lancet Date: 2014-04-04 Impact factor: 79.321
Authors: Marie-Aimee Muhimpundu; Fidele Ngabo; Felix Sayinzoga; Jean Paul Balinda; John Rusine; Sardis Harward; Arielle Eagan; Sara Krivacsy; Alice Bayingana; Jean Claude Uwimbabazi; Jean Damascene Makuza; Jean de Dieu Ngirabega; Agnes Binagwaho Journal: JCO Glob Oncol Date: 2021-04
Authors: Jean d'Amour Sinayobye; Marc Sklar; Donald R Hoover; Qiuhu Shi; Jean Claude Dusingize; Mardge Cohen; Eugene Mutimura; Brenda Asiimwe-Kateera; Philip E Castle; Howard Strickler; Kathryn Anastos Journal: Infect Agent Cancer Date: 2014-12-08 Impact factor: 2.965
Authors: Allen C Bateman; Katundu Katundu; Mulindi H Mwanahamuntu; Sharon Kapambwe; Vikrant V Sahasrabuddhe; Michael L Hicks; Benjamin H Chi; Jeffrey S A Stringer; Groesbeck P Parham; Carla J Chibwesha Journal: BMC Cancer Date: 2015-07-24 Impact factor: 4.430