Message from the President Dear Colleagues Welcome to the

Document Sample
Message from the President Dear Colleagues Welcome to the Powered By Docstoc
					Message from the President

Dear Colleagues,

Welcome to the inaugural issue of the IFCPC newsletter!

Thank you so much for your continuing support of the IFCPC. We are now half way through our three
years as a Board and I hope on your behalf, we are making progress in our mission to re-establish the
Federation as a flourishing international group. I have asked Secretary General Walter Prendiville,
Treasurer Jim Bentley, and the Chairs of our important subcommittees: President-elect Silvio Tatti of
the Science Committee, Christine Bergeron of the Education Committee, Jeffery Tan of the Information
Technology Committee, and Jacob Bornstein of the Nomenclature Committee to share their reports with
you in this Newsletter.

One of the first activities of the Board was to review and, ultimately, to reconfirm our mission:

A primary and general ambition of the Federation will be to try to reduce the burden of lower genital
tract cancer and, in particular, cervical cancer. To this end, the IFCPC has different responsibilities in
different regions: The primary responsibility in the developed world is to maintain standards and to
promote improvement through quality assurance, education and training. In the emerging economies,
the emphasis of the Federation will be to respond to individual needs through the focus on training and
education in colposcopy and the treatment of pre-invasive disease. To this end, the IFCPC will support
regional initiatives and those initiatives of other international agencies (e.g., the International Agency for
Research on Cancer). Consequently, much of our energy in the past year and a half has been the
fulfilment of educational training in our field. In recent times we have held our ‘Five Continents
Symposium’, at several major international congresses. The Symposium, which compares and contrasts
the challenges for those involved in the prevention of and care of women with cervical cancer, was held
in Australasia in Auckland, New Zealand during the 2008 World Congress in 2008 and again in October
2009 during the FIGO World Congress held in Cape Town, South Africa. In addition, several IFCPC
members attended the March 2010 teaching course held at the AOGIN meeting in Delhi, India.

Currently, we are preparing to conduct a joint teaching course with the European Federation for
Colposcopy and Lower Genital Tract Pathology (EFC) at their meeting in Berlin this May. A second
teaching course will then be held at the Latin American Federation meeting in Cartagena, Columbia this
October 2010. We have also jointly sponsored teaching courses with the EFC and the British Royal
College of Obstetricians and Gynaecologists in Lithuania last year and there is a planned course in
Kosovo in May. I was asked to speak recently also at the joint European Cervical Cancer Association
/PCCP meeting at the European Parliament in Brussels, Belgium, where many of the challenges in the
field for developing and developed countries were discussed.

Our treasurer, Jim Bentley has presided over an improvement in our finances following losses in the
world global recession. We rely, as you know on the generous subscription income of $5 dollars US
from each member of each national society. Over the years we have taken little, if any sponsorship
from industry. While this has allowed us a dispassionate position intellectually─which is important─it
also does somewhat restrict what we are able to achieve. I am keen, however, to pursue future
educational initiatives with vigour and to help with initiatives in education and awareness. Jeffery Tan’s
hard work improving the website continues. We aim to have an excellent attendance at the next two
World Congresses in Rio in 2011 and London 2014. It is our plan to offer special registration rates for
those from poorer countries. To those colleagues from North America, please think about bidding for
2017! Details are on the website which is worth navigating around as it continues to

Lastly, at the recent European Cervical Cancer Association meeting in Brussels, I was very struck as to
the enormous variance among the current problems facing the different countries. In the end,
however, it is the enthusiasm and dedication of health care workers and women themselves that will
make the difference. For some fortunate rich communities, the twin approaches of vaccination and
screening offer the dramatic potential to reduce an already low incidence of cervical cancer. For some
emerging economies, there are key decisions to be made as to which screening techniques to employ.
For the most deprived countries, even a nurse, a speculum, and an awareness campaign can make a
huge difference to screening improvements. Therefore, it is crucial the IFCPC, remain as a reservoir of
knowledge and expertise in colposcopy and cervical pathology to all these groups. To this end, I thank
you again for your membership and continuing support.

Patrick G. Walker

Secretary General’s Report

As we approach the half way mark in the term of this board it is perhaps a good time to reflect on
where the Federation is going, what it has achieved and what it hopes to do during the year and a half
before the next IFCPC World Congress and our AGM in Rio de Janeiro in July 2011. The IFCPC has
made a number of firm achievements. Firstly our finances are now on a sound footing. As detailed in
the President’s letter the Federation does not have limitless funds but it does have sufficient to meet
its’ annual expenditure. Sincere gratitude to Jim Bentley and to Kathy Poole.

Secondly a number of very successful seminars have happened in conjunction with coincident
International events. These include two major Global meetings, the FIGO meeting in Cape Town last
October and the Papilloma Virus meeting in Malmo in May 2009. The Federation has been very keen to
support regional colposcopy meetings and the IFCPC will have supported and held seminars at several
large regional meetings before we meet in Rio in July 2011. The Federation presented its’ aims and
ambitions at a joint platform with the EFC at the Eurogin meeting in Monte Carlo earlier in March of
this year, and hosted a seminar at the Asian sister to Eurogin which is the AOGIN meeting being
hosted in New Delhi between the 26th and 28th of March 2010. Finally the Federation will be holding
board meetings at the European Federation meeting in Berlin in May 2010 and at the Latin American
Federation meeting in Cartagena in October this year.

Ninety nine per cent of the world’s colposcopists live in the developed world and yet ninety nine
percent of the world’s cervical cancer occurs in the developing world. Those countries which have
achieved real reduction in cervical cancer incidence and mortality rates have done so with the
combined strategy of identifying women at risk using systematic screening programmes and managing
the screen positive women in colposcopy clinics. If the IFCPC is to contribute to a reduction in the
burden of cervical cancer globally it will need to find a role in one or both of these two strategies.

It is more difficult for the Federation to embrace a role in establishing screening programmes but
maybe it should become a more politically engaging body and try to lobby governments and health
strategists about the need to establish comprehensive and well organized screening programmes. As
for colposcopy training the Federation does have a real role, and a real expertise, amongst its’ huge
spectrum of members.

Almost certainly every colposcopist would like to help in training colleagues wish to be trained and in
circumstances where training is needed. There is a difficulty in deciding which training initiatives are
the most effective. For many years different member societies have run training courses in emerging
regions in order to foster the evolution of colposcopy and pre-cancer services. Often this has taken
the form of running a basic colposcopy course, either theoretical or hands on. These have, by and
large, been successful in that they have been popular. It is less certain if these courses leave a lasting
effect on the region in question.
Recently a number of newer initiatives have emerged. I am aware of some but not all of these. It
would be very useful if members of the Federation could write or email me with details of those
international training initiatives that they are aware of in their own countries or elsewhere. The
Federation would like to establish a database of any training or research initiatives that are happening
so that we may learn which ones are most effective and where the Federation might be able to help. I
have listed three different projects that I know of, each of which are quite different. Two are in place,
the last will hopefully start next year. Please let the secretary general know of any International
initiatives that you are aware of at

Peru : See and treat training programme
The US based organisation PATH had been involved in a number of health initiatives globally. It has
successfully collaborated with the IARC and other international agencies and is adept at harnessing
funds and personnel in order to achieve specific project goals. At Eurogin last month in Monte Carlo a
number of presentations described a training project supported by PATH for a see/screen/treat initiative
using VIA as the screening tool and cryocautery as the treatment modality. The training programme is
based at the National Cancer Centre in Lima. It appears to be thriving. The see/screen/treat approach
appears to have genuine support amongst a number of authorities.

Southern India : Video conference linked training
The project in Tamil Nadu arose out of discussions with Dr Sankaranarayanan from IARC who had
undertaken several studies of Visual Inspection in Ambilikai in Tamil Nadu and elsewhere in India.
After visiting this rural and disadvantaged community in Ambilikai and making contact with an
interested dept of Gynaecology in Coimbatore a collaboration between Dublin and the two centres in
Tamil began in 2008. After a basic course a dozen trainee colposcopists were recruited to become
trainee colposcopists. The collaboration was supported by the Dept of Health and the Health Research
Board in Ireland as well as the British Society for Colposcopy and Cervical Pathology. Initially the two
centres were equipped with new colposcopes and video image and data storage computer systems.
The training continues by way of a regular videoconference of interesting cases presented from Dublin
and Ambilikai and the hospital in Coimbatore. A number of theoretical and practical training courses
have taken place over the last two years. At the end of this year an exit exam will take place and
certificates of training awarded. This type of training is less expensive and disruptive than bringing
trainees for a year or more’s preceptorship at a colposcopy service in established colposcopy clinics. It
is still however relatively expensive, even if the equipment was already installed in the centre wishing
to train. The ultimate ambition of this collaboration is to establish a training centre in Southern India
so that when the screening programme begins (and it has been announced by the regional
government) there will be somewhere to train colposcopists to manage the patients who need
colposcopy. Although many of the screen positive patients may be managed at the site of screening in
the community it is likely that not all will be suitable for a screen and treat approach. The project
appears to have gone well and there are now several very keen and increasingly competent
colposcopists in Coimbatore and Ambilikai.

Sub Saharan Africa: Distance learning project
Whether or not ultimately a see/screen/treat plan turns out to be the best way to deliver an effective
cervical cancer prevention programme in Africa remains to be seen. It is likely that a proportion of
patients will still benefit from colposcopy mediated management and there are very few trained
colposcopists in Sub Saharan Africa. In discussions with both Prof Denny and Dr Sankaranaryanan it
appears that a distance training programme may be the most efficient means of training colleagues in
Sub Saharan Africa. The distances between colleagues who need training and training centres is vast,
there are too many who want to be trained and too few centres of excellence that could offer the
preceptorship / hands on individual training that is the model in much of the developed world. The
proposal for such a programme is relatively embryonic but would run along the following lines

  1.   The course will be lecture based and will be delivered during 2011
  2.   The programme will be structured
  3.   A core curriculum will be generated (as with many National Society training programmes)
  4.   Each lecture will be video recorded and sent by email / internet or by regular mail in disc form
  5.   Each lecture will be accompanied by recommended reading
  6.   delegates will progress from one lecture to the next after satisfying an exam pertinent to the
       lecture and ancillary reading material
          a. i.e. Listening/viewing the lecture once or twice
          b. Reading the related reference material
          c. Answering a mini exam on the relevant subject
          d. Progressing to the next lecture
  7.   The lecture course will be preceded by a basic colposcopy course in January 2011
  8.   The course will finish with an advanced course in December 2011
  9.   There will be an exit exam, perhaps OSCE in form immediately after the advanced course
 10.   There will be a certificate of completion
 11.   There should be a practical component even if it is just model / simulated
 12.   Delegates must have a colposcope, a computer and a population of women who have been or
       wish to be screened.
 13.   Ideally delegates will have or be provided with a videocapture system
 14.   Delegates will be charged a fee
 15.   The course will be undertaken in French and English
 16.   All lectures and course material will be vetted and passed by the Education Committee of the
 17.   The faculty for the course will need to be large, with most faculty members contributing one or
       two lectures each
 18.   The full faculty should be drawn from as wide a spectrum of Federation members as possible
 19.   There will be a smaller core faculty
          a. to assess individual delegate performance and ability to progress through the course (i.e. to
              assess the individual lecture exam answers)
          b. to provide the basic and advanced course
          c. to sanction the choice of lecturers and core curriculum content
 20.   Funding will be sought from outside the IFCPC but some funding will come from the IFCPC.
 21.   The IARC have offered its’ audiovisual department facilities in order to record high quality
       lectures. Several of the board of the IFCPC already have a store of such lectures available.

Look forward to seeing everybody in Brasil next year

Walter Prendiville

Chair’s Report: Education Committee

In 2009, there was a training course of the EFC shared with the IFCPC in Lithuania. As referenced
above, “The Five Continents” symposium held during the FIGO Cape Town congress was well attended
(i.e., around 300 persons) and allowed links with those in the African gynecology community interested
in the prevention of cervical cancer. The Education Committee has been asked to send training material
for the website.

For 2010, the training course planned by the EFC in Berlin will be jointly produced with the IFCPC,
with a joint educational committee meeting of the EFC and the IFCPC to be organized by Simon
Leeson and myself.

We hope to convince you, the members, to send the training materials (e.g., lectures, images) you
have collected over the years for inclusion in the 'Tuna' web colposcopy education program.

Future planned training courses will be held in Kosovo, Mexico, and Cartagena, Colombia.

Docteur Christine Bergeron

Chair’s Report: Information Technology (IT) Committee

In 2009, the IT committee worked on improving the website by regular updates, improving linkage to
the national colposcopy societies and relevant organisations, setting up a private 'forum' site to improve
communications for the Board and working committees, developing a 'blog' site to foster academic
discussions, and introducing the 'Tuna' web colposcopy education program. A Registry of
international collaboration projects of interest to members of IFCPC will also be available on the
website. For 2010, we will be promoting the utilisation of the IFCPC website to maximise benefits from
all these infrastructure updates.

Dr. Jeffrey Tan

Chair’s Report: Science Committee

The 14th World Congress of Cervical Pathology and Colposcopy will be held July 4-7, 2011 in Rio de
Janeiro, Brazil. The Congress will hosted by the Brazilian Society and additional details as to the
conference venue, preferred hotels, and social events will be posted as they become available to the
World Congress and IFCPC websites. The official language of the Congress will be in English with all
scientific sessions simultaneously translated into Portuguese. General themes for the scientific sessions
are posted here. Additional details as to faculty, specific lectures and debates, etc., will be posted
within the next few months.

As with prior World Congresses, abstracts will be presented. The initial submission date (also coinciding
with the advanced registration payment date) will be February 28, 2011. Notification of abstract
acceptance will be provided no later than May 20, 2011. To view the submission guidelines, please

Dr. Silvio Tatti

Chair’s Report: Nomenclature Committee

The Nomenclature Committee defined its mission as follows:

  a. To prepare an up-dated, user-friendly colposcopic nomenclature for colposcopists worldwide.
  b. To incorporate into the new nomenclature critiques that have been voiced since the 2002
  c. To add terminology of different loop excision techniques.
  d. To consider adding vulvar and vaginal nomenclature.
  e. To examine the current nomenclature by an evidence-based medicine approach.

Toward these aims the committee members exchanged ideas through e-mails and the web site
committee forum. Meetings were held in Tel-Aviv, Israel in July 2009, in Edinburgh, Scotland in
September 2009, and in Cape Town, South Africa in October 2009. A meeting with the executive
council was held in October 2009.

From the committee discussions, a nomenclature proposal and an evidence-based analysis of current
colposcopy nomenclature have been drafted. Members have committed themselves to review
controversial issues and discussions are still in process. The committee intends to present an advanced
draft in the congress of the European Federation of Colposcopy in May 2010 in Berlin, and then post it
on the open section of the IFCPC web site to enable review and response from IFCPC members. Their
comments will be considered in drafting the final proposal.

The new nomenclature proposal will be then presented and discussed at the world congress in Rio,
Brazil in July 2011, and will later be introduced and published as the official IFCPC colposcopy

The members of the IFCPC nomenclature committee: Jacob Bornstein, Chairman; Jim Bentley, Hope
Haefner, Peter Bosze, Frank Girardi, Michael Menton, Myriam Perrota, Walter Prendiville, Peter Russell,
Mario Sideri, Bjorn Strander, and Aureli Torne.

Dr. Jacob Bornstein