Acceptability and safety of thermal ablation treatment for cervical cytological abnormalities in Pretoria, South Africa

Abstract

BACKGROUND : Cervical cancer is one of the leading causes of cancer deaths in women, and 90% of the deaths occur in low- to middle-income countries (LMICs). Accessible cervical cancer screening and treatment options are an urgent priority. Thermal ablation (TA) is an alternative treatment option available for cervical premalignant conditions. The World Health Organization (WHO) has endorsed TA and published guidelines on its use. Most studies on the treatment’s efficacy, safety, and acceptability are from high-income countries. METHODS : A prospective cohort study that recruited women who presented with abnormal cytology results from three hospitals in Pretoria, South Africa. Colposcopy examinations were done to assess patients’ eligibility for TA. Post-treatment questionnaires were completed by participating doctors and women to assess the acceptability and safety profile of the treatment. Follow-ups were scheduled on day 7 to assess the safety profile further, and adverse events (AEs) were recorded. RESULTS : The analysis included 58 women. The mean age was 42.4 years. Our findings showed a safety rate of 91.4% and a patient satisfaction rate of 96.6%. All the participating doctors and women recommended the treatment. Most of our findings were consistent with those from previous studies. CONCLUSION : Our study demonstrated TA as a safe and acceptable treatment method for cervical premalignant conditions in low- resource settings. The treatment does not require expensive infrastructure and can be performed by generalist doctors.