ICAS - PREVENTION AND DETECTION OF BREAST AND CERVICAL CANCER

Taking a sample for PAP

Poster presentation at the International Conference on the control off cancer and tobacco, Washington

Patients from rural areas received treatment for pre-malignant lesions

Patient receiving medical care as part of the Ginecobono Program

Patient & Promoter of the Ginecobono Program.

Workshop with Ministry of Health Personnel (MINSA)

Cervical cancer is a preventable disease that affects an estimated 490,000 women each year, causing over 270,000 deaths worldwide. Central America has one the highest rates worldwide of deaths from cervical cancer. Nicaragua in particular has the highest rate in Central America and the second highest in Latin America, surpassed only by Haiti.

In Nicaragua, the death rate for cervical cancer ranks first in women 30 to 60 years old, higher than maternal mortality. 225 women died in 2006 from cervical cancer.

In 2000 ICAS established the "Comprehensive Program for Prevention and Detection of Cervical Cancer" and since 2005 has included prevention of breast cancer in the program.

The program provides an effective strategy in the fight against cancer at low cost. This is achieved through the distribution of vouchers known as GINECOBONOS to increase the coverage of screening for women in areas identified by the Ministry of Health (MINSA).

The program covers 3 major problems of great importance in Nicaragua:

1. Low access to Pap tests (a test used to detect cervical cancer), particularly in populations most at risk (women between 30 to 65 years).

2. Low quality of the Pap smear and procedures, resulting in high numbers of false positives and false negatives.

3. Inadequate or non-existent reference and record systems.

The program is designed to detect early pre-cancerous lesions of the cervix helping to save a significant number of lives. The objectives are as follows:

1. To provide access to free cancer screening to poor women at high risk of developing cancer.

2. To ensure monitoring and treatment of precancerous cervical lesions found.

3, To introduce breast examination practices to medical personnel and to the patients

4. To strengthen multi-sector and interagency collaboration between local NGOs, Ministry of Health, community organizations, and international agencies.

Vouchers are delivered to women where they live or interact, giving them the opportunity to take control of their health. It has been shown that the voucher strategy is very cost effective.

The program has received funding from the British Embassy and DFID (vouchers and Siuna Mulukuku), USAID (Profamilia vouchers in almost all departments of the country), Netherlands Embassy (SILAIS Managua); Gurdián Ortiz Foundation (SILAIS Jinotega, Matagalpa, Boaco, Carazo, Masaya, Granada, Rivas, Chinandega and León) and Life Building Project (Managua SILAIS).

Since 2005 the Ginecobono program has been funded by the Foundation Gurdián Ortiz (FOG). FOG has donated 24000 vouchers to the Ministry of Health free of charge.

PROGRAM ACHIEVEMENTS