ArticleInternational journal of cancer2016
Use of thermo-coagulation as an alternative treatment modality in a 'screen-and-treat' programme of cervical screening in rural Malawi.
Article in International journal of cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Implementation research on noncommunicable disease prevention and control interventions in low- and middle-income countries: A systematic review.PLoS medicine · 2022Pooled it
- Side effects and acceptability measures for thermal ablation as a treatment for cervical precancer in low-income and middle-income countries: a systematic review and meta-synthesis.Family medicine and community health · 2022Pooled it
- Residual or Recurrent Precancerous Lesions After Treatment of Cervical Lesions in Human Immunodeficiency Virus-infected Women: A Systematic Review and Meta-analysis of Treatment Failure.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Pooled it
- Economic evaluation of thermal ablation compared to cryotherapy and loop diathermy in a screen-and-treat approach to cervical cancer, Zambia.Bulletin of the World Health Organization · 2025Trial
- Comparison of acceptability & efficacy of thermal ablation (thermocoagulation) & cryotherapy in VIA positive cervical lesions: A pilot study.The Indian journal of medical research · 2023Trial
- Transformation Zone Assessment Using Visual Inspection With Acetic Acid Before and After Thermal Ablation: Implications for Follow-Up.JCO global oncology · 2023Trial
- Safety and Acceptability of Three Ablation Treatments for High-Grade Cervical Precancer: Early Data From a Randomized Noninferiority Clinical Trial.JCO global oncology · 2022Trial
- A Prospective Randomized Trial to Compare Safety, Acceptability and Efficacy of Thermal Ablation and Cryotherapy in a Screen and Treat Setting.Asian Pacific journal of cancer prevention : APJCP · 2020Trial
- Single visit screen-triage-treat strategy using GeneXpert-based HPV testing of self-collected cervicovaginal samples and thermal ablation treatment for cervical cancer prevention among women in Lilongwe, Malawi.International journal of cancer · 2026Article
- Screen-and-treat: a sustainable solution for cervical cancer elimination in low and middle income countries.BMJ oncology · 2026Review
- Client perspectives and satisfaction with integrating facility and community-based HPV self-sampling for cervical cancer screening with family planning: a mixed method study.BMC public health · 2025Article
- Cost-effectiveness of approaches to cervical cancer screening in Malawi: comparison of frequencies, lesion treatment techniques, and risk-stratified approaches.BMC health services research · 2024Article
- Acceptability and feasibility of implementing thermal ablation as a preventive cervical cancer treatment and the comparison of treatment outcome with cryotherapy in Zimbabwe.Ecancermedicalscience · 2024Article
- Gynecologic infection rates after ablation treatment for cervical intraepithelial neoplasia grade 2 and higher (CIN2+): Secondary analysis of a non-inferiority randomized trial.PLOS global public health · 2024Article
- Efficacy of thermal ablation for treatment of biopsy-confirmed high-grade cervical precancer among women living with HIV in Kenya.International journal of cancer · 2023Article
- Cervical cancer screening outcomes in public health facilities in three states in Nigeria.BMC public health · 2023Article
- "When You Have Gotten Help, That Means You Were Strong": A Qualitative Study of Experiences in a "Screen and Treat" Program for Cervical Cancer Prevention in Malawi.Journal of cancer education : the official journal of the American Association for Cancer Education · 2022Article
- A novel cervical cancer screen-triage-treat demonstration project with HPV self-testing and thermal ablation for women in Malawi: Protocol for a single-arm prospective trial.Contemporary clinical trials communications · 2022Article
- Acceptability and safety of thermal ablation to prevent cervical cancer in sub-Saharan Africa.BMC cancer · 2022Article
- Thermal Ablation Treatment for Cervical Precancer (Cervical Intraepithelial Neoplasia Grade 2 or Higher [CIN2+]).Methods in molecular biology (Clifton, N.J.) · 2022Review
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The incidence of cervical cancer in Malawi is the highest in the world and projected to increase in the absence of interventions. Although government policy supports screening using visual inspection with acetic acid (VIA), screening provision is limited due to lack of infrastructure, trained personnel, and the cost and availability of gas for cryotherapy. Recently, thermo-coagulation has been acknowledged as a safe and acceptable procedure suitable for low-resource settings. We introduced thermo-coagulation for treatment of VIA-positive lesions as an alternative to cryotherapy within a cervical screening service based on VIA, coupled with appropriate, sustainable pathways of care for women with high-grade lesions and cancers. Detailed planning was undertaken for VIA clinics, and approvals were obtained from the Ministry of Health, Regional and Village Chiefs. Educational resources were developed. Thermo-coagulators were introduced into hospital and health centre settings, with theoretical and practical training in safe use and maintenance of equipment. A total of 7,088 previously unscreened women attended VIA clinics between October 2013 and March 2015. Screening clinics were held daily in the hospital and weekly in the health centres. Overall, VIA positivity was 6.1%. Almost 90% received same day treatment in the hospital setting, and 3- to 6-month cure rates of more than 90% are observed. Thermo-coagulation proved feasible and acceptable in this setting. Effective implementation requires comprehensive training and provider support, ongoing competency assessment, quality assurance and improvement audit. Thermo-coagulation offers an effective alternative to cryotherapy and encouraged VIA screening of many more women.
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