are treatments for cervical precancerous lesions in less-developed countries safe enough to promote scaling-up of cervical screening programs a systematic review颈癌前病变的治疗方法在欠发达国家足够安全,促进扩大宫颈癌筛查项目的系统回顾.pdfVIP

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are treatments for cervical precancerous lesions in less-developed countries safe enough to promote scaling-up of cervical screening programs a systematic review颈癌前病变的治疗方法在欠发达国家足够安全,促进扩大宫颈癌筛查项目的系统回顾.pdf

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Chamot et al. BMC Women’s Health 2010, 10:11 /1472-6874/10/11 RESEARCH ARTICLE Open Access Are treatments for cervical precancerous lesions in less-developed countries safe enough to promote scaling-up of cervical screening programs? A systematic review Eric Chamot1*, Sibylle Kristensen1†, Jeffrey SA Stringer2†, Mulindi H Mwanahamuntu2,3† Abstract Background: Since the mid-1990s, there have been growing efforts to prevent cervical cancer in less-developed countries through the development of innovative screening approaches such as visual inspection of the cervix associated with same day management of cervical lesions with cryotherapy or loop electrosurgical excision procedure (LEEP). In the past, promising cancer screening interventions have been widely promoted despite incomplete evidence, only to become the subject of intense controversies about ensuing net health benefit. Because the efficacy and effectiveness of the new protocols for global cervical cancer screening have not been well characterized yet, and as a contribution to the evaluation of the balance between the benefits and risks of these protocols, we reviewed the literature on the safety of cryotherapy and LEEP for cervical intraepithelial neoplasia (CIN) in low- and middle-income countries. Methods: We searched 12 databases (Medline, Google Scholar, Scopus, Cochrane Library, Web of Science, OCLC, PAIS International Database, WHO Global Health Library, CINAHL, S, NYAM Grey Literature Report, and POPLINE) for original research published between January 1995 and April 2009. Both peer-reviewed publications and items of “grey” literature were retrieved; no language restriction was applied. We calculated the median (minimum, maximum) reported rate for each harm considered. Because of limitations and heterogeneity in the data, no formal meta-analysis was