Opportunities and challenges in cervical cancer screening program in Kazakhstan: Results after imPACT review.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18020-e18020
Author(s):  
Dilyara Kaidarova ◽  
Raikhan Bolatbekova ◽  
Alma Zhylkaidarova ◽  
Tolkyn Sadykova ◽  
Yerlan Kukubassov ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Mortality Rate ◽  
Screening Program ◽  
Early Stage ◽  
Gynecological Cancer ◽  
Cervical Screening ◽  
Pap Test ◽  
Target Population ◽  
Developed Countries ◽  
Screening Programs

e18020 Background: Cervical cancer is the second most common cancer in women worldwide, where the majority of registered patients are in developing countries. Screening programs in developed countries have reduced morbidity and mortality from cervical cancer by more than 2 times. Cervical cancer (CC) is the most common gynecological cancer in Kazakhstan (KZ). Standardized incidence rate of CC was 18.2 per 100,000, while the mortality rate was 6.2 per 100,000, in 2019. The National Cervical Screening program in KZ uses cytology (Pap test) from 2008. Screening program funded by the State budget. In 2016, Experts of imPACT Mission analyzed the CC screening and made recommendations for improvement. Since 2018 target age of CC screening expanded to 30-70 years and shortened the interval to 4 years, strengthened the control of patients with pre-cancerous pathology. Until 2018, people came to a fixed age; today we start CC screening within the target age at any age at the time of the first visit. The purpose of this study is to analyze cytological screening results in KZ after imPACT recommendations. Methods: Coverage, the number of screened women, the level of pre-cancer detection and cervical cancer during screening have been obtained from specific reports (form № 025, № 08) for 2008-2019. Results: The total number of screened women was in 6.775.975. There is a decrease in the number of screened women by 32% from 2008 to 2017. Since improvement of CC screening we increased coverage from 49.9% in 2017 (abs. number 409.124) to 89% in 2019 (abs. number 954.322). According to the results of screening, 2603 cases of CC were registered in 12 years. Analysis of screening results showed a marked increase in the detection of CC with an increasing by 67%. The persentage of registered cases of ASH+HSIL increased from 0.136% to 0.673%. Conclusions: there has been an increase in the coverage by screening of the target population since the screening update. During the study period, there has been an improvement in the detection of precancerous pathology and cancer in the early stage. Despite the positive results of screening, sufficient coverage by screening, certain successes in detecting the initial stage of CC, mortality rate from CC remain high, which makes it necessary to improve the screening of CC in KZ through the introduction of HPV-screening.

scholarly journals Screening for Cervical Cancer in Kazakhstan

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 50s-50s ◽  
Author(s):  
D. Kaidarova ◽  
A. Zhylkaidarova ◽  
Z. Dushimova ◽  
R. Bolatbekova
Keyword(s):  
Cervical Cancer ◽  
Mortality Rate ◽  
Screening Program ◽  
Cervical Screening ◽  
Gynecologic Cancer ◽  
Developed Countries ◽  
Papanicolaou Test ◽  
Screening Programs ◽  
Initial Stage ◽  
Coverage Analysis

Background: Cervical cancer is the second most common cancer in women worldwide, where the majority of registered patients are in developing countries. Screening programs in developed countries have reduced morbidity and mortality from cervical cancer by more than 2 times. Cervical cancer (CC) is the most common gynecologic cancer in Kazakhstan. In 2016, the standardized incidence rate of CC was 19.1 per 100,000, while the mortality rate was 7.1 per 100,000. The National Cervical Screening program in Kazakhstan has been using cytology (The Papanicolaou test) since 2008, free for women aged 30 to 60 years and performed at 5-year intervals. Despite the introduction of cytologic screening, the mortality rate remains high. Aim: The purpose of this study is to analyze the effectiveness of cytologic screening in Kazakhstan. Methods: Coverage analysis, the number of screened women, the level of precancer detection and cervical cancer during screening have been obtained from specific reports (form no. 025, no. 08) for 2008-2016. Results: The number of screened women totaled at 4,460,320. There has been a decrease of 32% in the number of screened women within the nine-year period. Furthermore, the coverage rate has decreased within the said period by 27%, from 72.9% in 2008% to 45.9% in 2016, with the highest coverage in 2012. According to the results of the screening, 1576 cases of CC were registered. The analysis of the screening results showed a marked increase in the detection of CC with an increase of 37%. At the same time, the percentage of detection of the initial stage during screening remains insufficient and for 2016 was 50.8%. The percentage of registered cases of ASH+HSIL increased from 0.136% to 0.673%. Conclusion: An analysis of the cytologic screening for 2008-2016 showed a high incidence of CC. Despite sufficient coverage and relative success in detecting the initial stages of CC, the mortality rate remains high. Thus, it is necessary to improve the effectiveness of CC screening in Kazakhstan through the introduction of HPV-screening.

scholarly journals Role of Protein Biomarkers in the Detection of High-Grade Disease in Cervical Cancer Screening Programs

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Charlotte A. Brown ◽  
Johnannes Bogers ◽  
Shaira Sahebali ◽  
Christophe E. Depuydt ◽  
Frans De Prins ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
False Negative ◽  
Pap Test ◽  
Developed Countries ◽  
Protein Biomarkers ◽  
Ki 67 ◽  
Screening Programs

Since the Pap test was introduced in the 1940s, there has been an approximately 70% reduction in the incidence of squamous cell cervical cancers in many developed countries by the application of organized and opportunistic screening programs. The efficacy of the Pap test, however, is hampered by high interobserver variability and high false-negative and false-positive rates. The use of biomarkers has demonstrated the ability to overcome these issues, leading to improved positive predictive value of cervical screening results. In addition, the introduction of HPV primary screening programs will necessitate the use of a follow-up test with high specificity to triage the high number of HPV-positive tests. This paper will focus on protein biomarkers currently available for use in cervical cancer screening, which appear to improve the detection of women at greatest risk for developing cervical cancer, including Ki-67,p16INK4a, BD ProEx C, and Cytoactiv HPV L1.

Cervical cancer screening: Twelve years experience of the Kazakhstan National Screening program.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17520-e17520
Author(s):  
Raikhan Bolatbekova ◽  
Dilyara Kaidarova ◽  
Alma Zhylkaidarova ◽  
Tolkyn Sadykova ◽  
Yerlan Kukubassov ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Screening Program ◽  
Gynecological Cancer ◽  
Cervical Screening ◽  
Precancerous Lesion ◽  
Female Population ◽  
Incidence And Mortality ◽  
Screening Coverage

e17520 Background: Cervical cancer (CC) is the most common gynecological cancer in Kazakhstan (KZ). Standardized incidence rate of CC was 16.7 per 100, 000, while the mortality rate was 5, 9 per 100, 000, in 2020. The National Cervical Screening program in KZ uses cytology (Pap test) from 2008, which is free of charge for women aged 30 to 70 years of age with an interval of 4 years. In 2017 Experts from ImPact Mission and analyzed existing CC screening revealed a number of recommendations aimed at reducing the screening interval and increasing the coverage. The purpose of this study was to analyze results of CC screening in KZ and his impact on CC incidence and mortality. Methods: Coverage, the number of screened women, the level of pre-cancer detection and cervical cancer during screening have been obtained from specific reports (form № 025, № 08) for 2008-2020. Results: The total number of screened women for 2008 were 554 283 women. There is a decrease in screening coverage to 45.9% in 2017 due to a decrease in funding. in this regard, in 2017, a number of changes were made to the existing screening program. In 2020 after the CC screening improvement 786 690 women were examined during the screening program, coverage rate was 66, 2%, . Analysis of screening results showed a marked increase in the detection of precancerous lesion from 0, 136 in 2008 to 0, 87 with an increasing by 37%. The analysis of CC incidence revealed significant changes: after the introduction of screening, an increase in the incidence rate is noted from 15.5 in 2008 to 20.1 per 100, 000 female population in 2015. Since 2015, there has been a significant decrease to 16.7 per 100, 000 women. Conclusions: Despite the positive results of screening, an increse the screening coverage, improvement in the detection of the initial stage of CC, mortality rate from CC and a one-year mortality remain high, which makes it necessary to improve the screening of CC in KZ through the introduction of HPV-screening

Factors Affecting Uptake of Cervical Cancer Screening among Clinic Attendees in Trelawny, Jamaica

2007 ◽  
Vol 14 (4) ◽  
pp. 396-404 ◽  
Author(s):  
Patricia Bessler ◽  
Maung Aung ◽  
Pauline Jolly
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Pap Test ◽  
Preventive Measure ◽  
Developed Countries ◽  
Factors Affecting ◽  
Screening Programs ◽  
Attitudes And Practices

Background Use of the Pap test has resulted in a decline in cervical cancer mortality in developed countries. Yet, despite established cervical cancer screening programs, a significant portion of Jamaican women are not undergoing screening for cervical cancer. This study was carried out to identify factors that affect Jamaican women's decisions to screen for cervical cancer. Methods A population survey was administered to 367 clinic-attending women 25 to 54 years of age in the Parish of Trelawny from May to July of 2005. An interviewer-administered questionnaire assessed the women's knowledge, attitudes, and practices regarding cervical cancer and cervical cancer screening. Results Overall, 11% of the women had never had a Pap smear and only 38% had a Pap test within the last year. Annual visits to a health provider have a strong influence on women's decisions to regularly screen for cervical cancer. Provider recommendation also positively affected initial receipt of a Pap smear as well as continued regular screening. Conclusions Programs that promote annual health checkups, encourage consistent provider recommendations, and emphasize screening as a preventive measure might positively influence women's decisions to screen for cervical cancer.

scholarly journals Healthcare Providers´ Views on Cervical Screening: A Qualitative Study of Barriers to Cervical Screening in Malaysia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 214s-214s
Author(s):  
C.J. Yong ◽  
L.L. Hong ◽  
K.Y. Lee ◽  
I. Krishnasamy ◽  
N.H. Binti Nasir ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Perceived Risk ◽  
Healthcare Professionals ◽  
Screening Program ◽  
Cervical Screening ◽  
Healthcare Providers ◽  
Pap Test ◽  
Community Healthcare

Background: Cervical cancer is the third most common cancer affecting Malaysian women despite being highly preventable through screening. A national cervical cancer screening program has been established since 1969 to ensure early detection of cervical cancer. Nonetheless, the prevalence of cervical cancer in Malaysia remains high. Malaysia has been offering Pap tests for free in community health clinics since 1995, however only 47.3% of women have been screened. It has also been reported that nearly 40% of patients with cervical cancer presented at advanced stages of the disease. Government community healthcare professionals are the main stakeholders in the national cervical screening program. Therefore, understanding these healthcare professionals’ perspective of barriers associated with underutilization of cervical cancer screening is key to increase overall screening uptake. Aim: This study aimed to explore healthcare professionals’ views on perceived barriers to cervical screening in Malaysia. Methods: Qualitative in-depth semistructured interviews were carried out with 44 primary healthcare professionals consisting of family medicine specialists (N = 5), medical officers (N = 9), matrons and nurses (N = 20), laboratory technician (N = 5), registration staff and IT technicians (N = 5) involved in the cervical screening program at 5 different urban government healthcare clinics in Petaling district. The interviews were transcribed verbatim and analyzed using a thematic analysis approach. Results: Themes emerged were individual and system barriers. Individual barriers include knowledge/risk perception (lack of knowledge and awareness of cervical screening, low perceived risk), distress (Pap test is embarrassing or painful, previous negative Pap test experience and fear of a cancer diagnosis) and coping skills (remembering the appointment, managing responsibilities such as getting child care/elder care/coverage at work, ability to get transportation), social-cultural barrier (family support); while system barriers highlight the long waiting time for cervical screening, poor documentation, no national call-recall system, patient overload, lack of resources and manpower, lack of educational materials and problems with opportunistic screening. Conclusion: Sustainable screening interventions require approaches that address and resolve both individual and system barriers, such as exploring new methods and delivery of cervical screening, and providing education for the public and healthcare providers.

scholarly journals Understanding the Acceptability and Uptake of HPV Self-Sampling Amongst Women Under- or Never-Screened for Cervical Cancer in Toronto (Ontario, Canada): An Intervention Study Protocol

2021 ◽  
Vol 18 (17) ◽  
pp. 9114
Author(s):  
Aisha Lofters ◽  
Kimberly Devotta ◽  
Vijayshree Prakash ◽  
Mandana Vahabi
Keyword(s):  
Cervical Cancer ◽  
Screening Program ◽  
Middle Eastern ◽  
Cervical Screening ◽  
Pap Test ◽  
Health Concern ◽  
Global Public Health ◽  
Structured Interviews ◽  
Will Self ◽  
Never Screened

Cervical cancer remains a global public health concern, even though scientific advancements have made the disease almost entirely preventable. With the link between human papillomavirus (HPV) and cervical cancer, and the subsequent improvement in screening technology, there is potential to improve access and coverage of cervical screening with the introduction of HPV self-sampling. In Ontario, Canada, a province with a cytology-based screening program (i.e., Pap test), women who identify as South Asian, West Asian, Middle Eastern and North African have some of the lowest rates of screening, and research suggests they have a higher burden of cervical cancer. In this study, we will use both quantitative and qualitative methods to understand the acceptability and uptake of a take-home HPV self-sampling kit. Working with community champions—people with pre-existing connections with local groups—we will recruit women from these groups who are under- or never-screened for cervical cancer. Women will self-select whether they are in the group that tries HPV self-sampling or in the group that does not. We will aim for 100 women in each group. All participants will provide feedback on the feasibility, acceptability and preferences for cervical screening through a survey and phone follow-up. Women who self-select the HPV self-sampling group, will be followed up to find out if they followed through with self-sampling and to understand their experience using the device. Women who do not want to try self-sampling will be followed up to see if they went on to get a Pap test. The qualitative phase of this study consists of five focus groups with participants and semi-structured interviews with key informants in the community.

scholarly journals Algarve Cervical Cancer Screening Programme

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Correia ◽  
A Pacheco ◽  
J Morera ◽  
R Pereira ◽  
D Ferrinho ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Early Diagnosis ◽  
Screening Programme ◽  
Screening Program ◽  
Life Quality ◽  
Target Population ◽  
Screening Programs ◽  
Hpv Test ◽  
Adhesion Rate ◽  
Aggressive Interventions

Abstract Issue Cervical Cancer (CC) is the 7th most frequent and the 2nd most common in women. The standardized mortality rate, in Portugal is 2.3/100000 inhabitants and Algarve is the region with highest rate, 4.9/100000. Description Programme started in 2010. Population-based screening programme can reduce incidence, mortality and morbidity with an early diagnosis, preventing aggressive interventions in precancerous phase, improving survival and life quality. Target population, woman age 25-64.are invited to primary test liquid-based cytology (ThinPrep) every 3 years. Health Centres are responsible for select, invite, collect samples and send to Hospital laboratory. For positives, a cervical pathology consultation is required. National Guidelines now indicates DNA testing for human papillomavirus (HPV) as primary screening test, each 5 years, to woman age 25 to 60 and screening program changes will be implemented in 2019 with improved response time and lower cost. Results Since 2010 the target population has increased 12% every 2 years and the adhesion rate increased ≈68% and≈108%. Nevertheless the 3rd cycle has showed 10,8% (17.975) adhesion rate. Most women 16.112 (89.6%) had a negative diagnosis, 503 (2,8%) is ASC-US + (HPV test), and 761(4,2%) had a cervical pathology consultation. From those, 117 (15.4%) had a LSIL, 69 (9,1%) HSIL and 2(0,3%) cancer. Cancer detection rate is 0,1 ‰. Lessons The small adhesion rate particularly by aged women, the users unfriendly Information System and direct screening health units management are some of the issues that requires improvement. Also population literacy, self-sampling vaginal fluid and clinical meetings are some of the options to improve screening program. Key messages Cervical Cancer early diagnosis prevent aggressive interventions in a precancerous phase, improves survival and life quality. Better access and health communication are major points in screening programs.

scholarly journals Methods for screening and prevention of HPV infection – a retrospective study

2021 ◽  
Vol 24 (1) ◽  
pp. 51-57
Author(s):  
Catalina Diana Stanica ◽  
◽  
Romina Marina Sima ◽  
Raluca Gabriela Ioan ◽  
Constantin Dimitrie Nanu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Retrospective Study ◽  
Screening Program ◽  
Cervical Screening ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Female Population ◽  
Vaccination Programs ◽  
Screening Programs ◽  
Incidence And Mortality

Worldwide, cervical cancer ranks 4th in frequency in the female population, with about half of the cases being fatal. In Romania, it is the second type of cancer found in women, after breast cancer and the main cause of cancer mortality in patients aged between 15 and 44 years. The main cause of this type of cancer is human papilloma virus (HPV) infection. Although HPV is very widespread (> 85%), progression to cervical cancer is relatively rare. In countries that have implemented cervical screening programs, the incidence and mortality caused by this pathology have decreased by 50-75%. Also, the emergence of vaccines against the most common strains of oncogenic HPV and the implementation of vaccination programs will bring additional benefits in preventing cervical cancer. This paper presents the results of a retrospective study, performed on a number of 92 patients, which aimed to know the distribution of different HPV genotypes, their impact on the cervical epithelium, the degree of access to the national screening program, and openness to anti HPV vaccination.

EPIDEMIOLOGY OF CERVICAL CANCER IN THE REPUBLIC OF KAZAKHSTAN FOR 10 YEARS (2007-2016)

2017 ◽  
Vol 63 (4) ◽  
pp. 572-579
Author(s):  
Dilyara Kaydarova ◽  
M. Kayrbaev ◽  
R. Bolatbekova
Keyword(s):  
Cervical Cancer ◽  
Detection Rate ◽  
Screening Program ◽  
Gynecological Cancer ◽  
Cervical Screening ◽  
Invasive Cervical Cancer ◽  
Significant Risk ◽  
Incidence Rates ◽  
Female Population ◽  
The Republic

Invasive cervical cancer is the most common form of gynecological cancer in Kazakhstan, which occupies the 5th position among all neoplasias and the 10th place in mortality of the general population. The national cervical screening program in the Republic of Kazakhstan uses cytology (Pap test) from 2008, which is free of charge for women aged 30 to 60 years with an interval of 5 years. In the analysis of intensive incidence rates of cervical cancer it is noted an increase in the detection rate of this disease in the period from 2007 to 2016: in 2007 the incidence was 15.3 per 100 000 female population, and in 2016 to 19.1 per 100 000 female population. The analysis of age in incidence rates showed a significant risk of the disease at a young age and a noticeable increase it to 4044 years. In the analysis of cervical cancer in the context of the stages it is marked an increase in the detection rate of the disease in the first stage, for the period from 2007 to 2016.

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