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WHO recommends that the feasibility of downstaging be studied and contemplated in areas where cytological screening would not be possible for many years and where the majority of the cases of cervical cancer are diagnosed at an advanced stage. (1986)


Downstaging is an experimental procedure whose benefits have not been established.  Downstaging was introduced in Kerala, India where women were informed of the symptoms of the disease and asked to report it to the health workers if they appeared.  As a result, the proportion of cervical cases diagnosed at Stages I and II rose from 15% to 45% whereas the proportion of those diagnosed at Stage III and IV fell from 85% to 55% (WHO, 1992)


visual inspection