Course for master trainers on cervical cancer screening and treatment of precancerous lesions

Morocco’s National Plan for Cancer Prevention and Control prioritizes screening for cervical and breast cancers. They have chosen to screen for cervical cancer using visual inspection with acetic acid (VIA), and aim to screen a target population of women aged 30–50 years. With this aim in mind, the Moroccan Ministry of Health (MoH) in collaboration with the Lalla Salma Foundation for Cancer Prevention and Treatment and the United Nations Population Fund (UNFPA) asked the IARC Screening Group (SCR) to organize a master trainer course for 15 Moroccan general practitioners and gynaecologists. SCR obtained funds from the Union for International Cancer Control (UICC) through a Global Education and Training Initiative (GETI) fellowship to cover a large portion of the costs. The course was hosted at the Nargis Dutt Memorial Cancer Hospital (NDMCH) in Barshi, Maharashtra, India, on 16–20 November 2014, and was attended by 14 general practitioners, 2 gynaecologists, and 2 administrators from the MoH and UNFPA. The programme, delivered in French, included foundational theoretical training on the following topics:

• Anatomy and physiology of the lower genital tract, with particular emphasis on the cervix
• Natural history and pathology of cervical neoplasia
• Visual inspection with acetic acid (VIA) and with Lugol’s iodine (VILI)
• Introduction to colposcopy
• Colposcopic appearances of the normal cervix and of inflammation and other benign conditions of the cervix
• Treatment of precancerous lesions by thermocoagulation
• Treatment of precancerous lesions by loop electrosurgical excision procedure (LEEP)

The theoretical sessions were followed by 2.5 days of practical training during which each participating trainee received hands-on experience. A total of 122 Indian women attended the screening clinics, which provided the opportunity for experiential training in visual inspection and colposcopy procedures. Of the women screened, 26 were diagnosed with cervical precancerous lesions. Of these, 12 underwent treatment with thermocoagulation and 14 underwent LEEP, carried out by the participants under supervision of the faculty.

The course was very well received and positively evaluated.