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COMPREHENSIVE CERVICAL CANCER CONTROL C4

This presentation discusses the status of cervical cancer control in the Cook Islands, highlighting the national screening program initiated in 1960, current screening practices (75% coverage, approximately 600 women screened annually using cytology and VIA), and the treatment options available at Rarotonga Hospital. Challenges such as resource constraints, public awareness, and access are examined, alongside opportunities leveraging pre- and post-natal periods for outreach. Additionally, the introduction of the HPV vaccine is discussed, including planning, immunization, and challenges faced.

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COMPREHENSIVE CERVICAL CANCER CONTROL C4

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  1. COMPREHENSIVE CERVICAL CANCER CONTROLC4 Country: COOK ISLANDS Presenters: Dr Rangi FARIU & Acing-Chief Nurse Rufina TUTAI.

  2. 1. Status of National Programme • Year of starting: 1960 • Responsible unit:Community Health Services, Hospital Health Services , Outer Islands Health Services & Cook Islands Family Welfare Association • Financing:Ministry of Health • Components: Clinicians, Lab, Hospitals, Donors • Current status-In Progress

  3. 2. Screening for cervical cancer • Test used-Cytology & VIA • Coverage-75% • Number screened per year-About 600 • Limitations- resource constraints, access and beliefs.

  4. 3. Cancer treatment • Number of centres offering treatment for cervical cancer-Rarotonga Hospital • Radiotherapy availability-Nil • Brachytherapy- Nil • Most common stage at presentation – Pre-cancerous or late-stage

  5. 4. Monitoring and evaluation • Cancer registry-Yes • Since...... • Population covered by cancer registry-YES • Incidence rate of cervical cancer-

  6. 5. Challenges and opportunities for cervical cancer control • Challenges- • Resources-Human & Financial • Transportation • Difficulty in attracting non pregnant but sexually active women • Ignorance, lack of awareness • Competing priorities – family members before self • Private GPs no inolved. • Opportunities • ‘captured audience’ situation during pre- & post natal period. • Assistance for screening by CIFWA(NGO) • Effective Outreach Program

  7. Opportunities Cont…. • Quick Turn around of results • Ease of taking Smears-VIA

  8. 7. HPV vaccination: Decision-making and planning [for countries with HPV vaccination programme or immediately planned] Factors that led to decision to introduce HPV vaccine- High STI Rates - Funding sources for vaccine and operational costs- WHO & MOH Vaccine selected-Cervarix Type 16/18 Communications with community, schools, health staff and others to prepare for vaccine introduction- Multi Media Approach. Letters to the Parents via School Principals

  9. 8. HPV vaccination: Immunization systems [for countries with HPV vaccination programme or immediately planned] Location: school-based, health centres Staff who administer vaccine-Public Health Nurses System to obtain parental consent-Given to the kids in the school Monitoring forms used-Med Tech, HPV Registration Form System for follow-up of absent or missed girls-Public Health Nurses

  10. 9. HPV vaccination: Challenges in implementation and solutions found [for countries with HPV vaccination programme or immediately planned] [may expand this to two slides if needed] Sustainability of funding, support by policymakers- Maybe able to be absorbed into our Local Budget but with great difficulty Acceptance of (or demand for) HPV vaccination by parents, girls, school and health officials Logistics of delivery in schools or other locations Attaining high coverage for first dose and complete series Others

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