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

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 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.

scholarly journals National and Subnational Trends of Incidence and Mortality of Female Genital Cancers in Iran; 1990–2016

2020 ◽  
Vol 23 (7) ◽  
pp. 434-444
Author(s):  
Sahar Eftekharzadeh ◽  
Narges Ebrahimi ◽  
Mehrnoosh Samaei ◽  
Farnam Mohebi ◽  
Bahram Mohajer ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Incidence Rate ◽  
Gynecological Cancer ◽  
Fold Increase ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Gynecological Cancers ◽  
Corpus Uteri ◽  
National Mortality ◽  
Incidence And Mortality

Background: The present study aims to assess the incidence and mortality rates of gynecological cancers and their changes from 1990 to 2016 at national and subnational levels in Iran. Methods: Annual estimates of incidence and mortality for gynecological cancers from 1990 to 2016 at national and subnational levels were generated as part of a larger project entitled National and Subnational Burden of Diseases, Injuries, and Risk Factors (NASBOD). After the precise processing of data extracted from the Iran Cancer Registry, annual age-standardized incidence and mortality rates were calculated for each cancer, province, year and age group during the period of the study. Results: In 2016, gynecological cancers constituted 8.0% of new cancer cases among women of all ages compared to 3.7% of new cases of cancer among women in 1990. The incidence rate of gynecological cancers has increased from 2.5 (0.9-5.6) per 100000 women in 1990 to 12.3 (9.3–15.7) per 100000 women in 2016, and the most common gynecological cancer has changed from cervical cancer in 1990 to corpus uteri cancer in 2016. Age-standardized incidence rates of ovarian, corpus uteri and vulvovaginal cancers increased from 1.3 (0.5–2.4), 1.7 (0.6–3.0), and 0.3 (0.0–0.7) in 1990 to 4.4 (3.6–5.2), 9.9 (6.8–13.4), and 0.6 (0.2–1.0) in 2016, respectively, showing a 3.3, 5.8 and 1.7-fold increase during this period. Age-standardized incidence rate of cervical cancer was 2.4 (1.7–3.3) cases per 100000 women in 2016 and did not differ significantly from the beginning of the study. An overall reduction was seen in national mortality to incidence ratios (MIR) from 2000 to 2015. Conclusion: The incidence rates of all gynecological cancers in different provinces have shown a converging trend that could indicate that attempts toward health equality have been effective. The declining trend of MIR could be interpreted as advancements in detection of cancer in its early stages and also improvements in treatments, in turn reflecting improvements in access to and quality of care.

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 Long-Term Exposure to Fine and Coarse Particulate Matter and COVID-19 Incidence and Mortality Rate in Chile during 2020

2021 ◽  
Vol 18 (14) ◽  
pp. 7409
Author(s):  
Macarena Valdés Salgado ◽  
Pamela Smith ◽  
Mariel Opazo ◽  
Nicolás Huneeus
Keyword(s):  
Mortality Rate ◽  
Incidence Rate ◽  
Air Pollutants ◽  
Negative Binomial ◽  
Transport Model ◽  
Surface Concentration ◽  
Mortality Rates ◽  
Incidence And Mortality ◽  
Pm2.5 And Pm10

Background: Several countries have documented the relationship between long-term exposure to air pollutants and epidemiological indicators of the COVID-19 pandemic, such as incidence and mortality. This study aims to explore the association between air pollutants, such as PM2.5 and PM10, and the incidence and mortality rates of COVID-19 during 2020. Methods: The incidence and mortality rates were estimated using the COVID-19 cases and deaths from the Chilean Ministry of Science, and the population size was obtained from the Chilean Institute of Statistics. A chemistry transport model was used to estimate the annual mean surface concentration of PM2.5 and PM10 in a period before the current pandemic. Negative binomial regressions were used to associate the epidemiological information with pollutant concentrations while considering demographic and social confounders. Results: For each microgram per cubic meter, the incidence rate increased by 1.3% regarding PM2.5 and 0.9% regarding PM10. There was no statistically significant relationship between the COVID-19 mortality rate and PM2.5 or PM10. Conclusions: The adjusted regression models showed that the COVID-19 incidence rate was significantly associated with chronic exposure to PM2.5 and PM10, even after adjusting for other variables.

scholarly journals Smartphone-Enhanced Training, QA, Monitoring, and Evaluation of a Platform for Secondary Prevention of Cervical Cancer: Opportunities and Challenges to Implementation in Tanzania

2020 ◽  
pp. 1114-1123
Author(s):  
Karen Yeates ◽  
Erica Erwin ◽  
Zac Mtema ◽  
Frank Magoti ◽  
Simoni Nkumbugwa ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Visual Inspection ◽  
Screening Program ◽  
Cervical Screening ◽  
Monitoring And Evaluation ◽  
Visual Assessment ◽  
Cervical Cancer Prevention ◽  
Supportive Supervision ◽  
Health Providers

PURPOSE Until human papillomavirus (HPV)–based cervical screening is more affordable and widely available, visual inspection with acetic acid (VIA) is recommended by the WHO for screening in lower-resource settings. Visual inspection will still be required to assess the cervix for women whose screening is positive for high-risk HPV. However, the quality of VIA can vary widely, and it is difficult to maintain a well-trained cadre of providers. We developed a smartphone-enhanced VIA platform (SEVIA) for real-time secure sharing of cervical images for remote supportive supervision, data monitoring, and evaluation. METHODS We assessed programmatic outcomes so that findings could be translated into routine care in the Tanzania National Cervical Cancer Prevention Program. We compared VIA positivity rates (for HIV-positive and HIV-negative women) before and after implementation. We collected demographic, diagnostic, treatment, and loss-to-follow-up data. RESULTS From July 2016 to June 2017, 10,545 women were screened using SEVIA at 24 health facilities across 5 regions of Tanzania. In the first 6 months of implementation, screening quality increased significantly from the baseline rate in the prior year, with a well-trained cadre of more than 50 health providers who “graduated” from the supportive-supervision training model. However, losses to follow-up for women referred for further evaluation or to a higher level of care were considerable. CONCLUSION The SEVIA platform is a feasible, quality improvement, mobile health intervention that can be integrated into a national cervical screening program. Our model demonstrates potential for scalability. As HPV screening becomes more affordable, the platform can be used for visual assessment of the cervix to determine amenability for same-day ablative therapy and/or as a secondary triage step, if needed.

Cervical neoplasia

2019 ◽  
pp. 357-364
Keyword(s):  
Cervical Cancer ◽  
Screening Program ◽  
Cervical Screening ◽  
Hpv Vaccination ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Cervical Neoplasia ◽  
Women Living With Hiv ◽  
The Bethesda System ◽  
Common Malignancy

Cervical neoplasia provides an overview of the 4th most common malignancy in women worldwide, including the premalignant phase. Specific terminology used in cytology and histology (including atypia, dyskaryosis, cervical intraepithelial neoplasia (CIN), cervical glandular intraepithelial neoplasia (CGIN) and invasive cervical cancer (ICC) are explained, and the epidemiology and risk factors (with an emphasis on human papilloma virus (HPV)) for this common malignancy are included. Clinical presentation is outlined. Cervical screening is discussed, including the role of HPV testing, and both the British Association for Cytopathology/NHS cervical screening program 2013 classification of cervical cytology and the Bethesda system (used more widely worldwide) are explained. Diagnosis includes colposcopic examination of the cervix, and the management of both CIN and cervical cancer are included. HPV vaccination, pregnancy, and women living with HIV (including ICC as AIDS-defining) are discussed.

scholarly journals Pattern of Cervical Screening Utilization in Italy

1989 ◽  
Vol 75 (5) ◽  
pp. 420-422 ◽  
Author(s):  
Monica Ferraroni ◽  
Carlo La Vecchia ◽  
Romano Pagano ◽  
Eva Negri ◽  
Fabio Parazzini ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Screening Program ◽  
Cervical Screening ◽  
Age Groups ◽  
National Health Survey ◽  
Italian Population ◽  
Common Procedure ◽  
Quantitative Evidence ◽  
Italian Women ◽  
Substantial Decline

The pattern of cervical screening utilization in Italy was analyzed using data from the 1986-1987 National Health Survey on the basis of a sample of 27,455 women aged 20 to 79 randomly selected within strata of municipality of residence and age in order to be representative of the whole Italian population. Overall, about 17% of women aged 20 to 79 were screened per year, for a total of 3.5 to 4 million cervical smears per year. The highest frequency was reported in younger middle age, about one in four women being screened per year in the age groups 30 to 49, and there was a substantial decline above age 50. Cervical smear rates were higher in Northern areas (22 %), where mortality from cervical cancer is lower, than in the Centre (16%) and South (11 %) of the country. Further, there was a strong positive social class gradient in the utilization of cervical screening, in relation to both education and occupation. In spite of the absence of any organised mass screening program, cervical screening is a relatively common procedure among Italian women. However, this study provides further quantitative evidence of a markedly irrational utilization of non-organized cervical screening, which tends to end up selectively used by the groups in which cervical cancer is less common.

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