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.

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

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.

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.

Investigation of the effect of occult invasive cancer on progress towards successful cervical screening

1998 ◽  
Vol 5 (2) ◽  
pp. 92-98 ◽  
Author(s):  
A Herbert ◽  
T N Bryant ◽  
M J Campbell ◽  
J Smith
Keyword(s):  
Cervical Cancer ◽  
At Risk ◽  
Linear Trend ◽  
Cervical Screening ◽  
Invasive Cervical Cancer ◽  
Invasive Disease ◽  
European Population ◽  
Significant Linear Trend ◽  
Female Population ◽  
Stage Ia

Objectives To describe the effect of occult invasive disease on progress towards meeting the Health of the Nation target for reducing the incidence of cervical cancer, and to investigate the possible effect of a higher risk of cervical cancer in women born since 1940. Setting Southampton and South West Hampshire (SSWH), with a total female population of 218 549 in 1990, the midpoint of a study period covering 1985 to 1995. Methods Incidence was calculated per 100 000 women years at risk in overlapping three year periods for symptomatic and screen detected cancers. The same method was used for cohorts of women born before and after 1940. Screen detected stage Ia1 cancers were identified as a subgroup. Results The incidence of invasive cervical cancer fell by 27.4%, from 16.8 to 12.2 per 100 000 women years at risk between 1985–87 and 1993–95, which was a significant linear trend (χ2=4.494, df=1, p=0.034). The corresponding figures adjusted for age in a standardised European population were 16.3 and 11.5: a fall greater than required to meet the Health of the Nation target set for the year 2000. Incidence remained relatively high until screen detected cancers, more than one third of which were stage Ia1, had passed a peak in 1992. When screen detected stage Ia1 cancers were excluded, incidence fell by 41.2%, from 16.5 to 9.7 per 100 000 women years at risk: a highly significant linear trend (χ2=12.391, df=1, p<0.001). The incidence in the first three years of the study was higher in women born between 1940 and 1954 than in those born between 1925 and 1939, though the reverse would be expected by age and the natural history of the disease. In the 1940–54 birth cohort 44% (23/52) of screen detected cancers were stage Ia1, with a peak in 1992. When these were excluded, incidence fell by 57.1%, from 31.7 to 13.6 per 100 000 women years at risk: a highly significant linear trend (χ2=13.704, df=1, p<0.001), whereas an increase would be expected for a cohort aged from 30–45 to 40–55. In the 1925–39 cohort only 24% (8/33) of screen detected cancers were stage Ia1. When these were excluded, incidence fell by 35.3%, from 24.9 to 16.1, which was not a significant linear trend (χ2=0.409, df=1, p=0.522). Conclusion An overall decline in incidence was not achieved until prevalent occult invasive disease had been detected by improved screening. The data confirm the effectiveness of screening, particularly in a high risk cohort of women born between 1940 and 1954.

scholarly journals Nationwide Rereview of Normal Cervical Cytologies before High-Grade Cervical Lesions or before Invasive Cervical Cancer

2021 ◽  
pp. 1-8
Author(s):  
Henrik Edvardsson ◽  
Jiangrong Wang ◽  
Bengt Andrae ◽  
Pär Sparén ◽  
Björn Strander ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Screening Program ◽  
Cervical Screening ◽  
Invasive Cervical Cancer ◽  
False Negative ◽  
Cancer Control ◽  
Adenocarcinoma In Situ ◽  
High Grade ◽  
Cervical Lesions ◽  
Normal Cytology

Sweden has experienced an unexpected &#x3e;30% increase in cervical cancer incidence among women with normal cytological screening results. We therefore performed a nationwide assessment of false-negative cytology before invasive cervical cancer. The Swedish national cervical screening registry identified 2,150 normal cytologies taken up to 10 years before 903 cases of invasive cervical cancer. The 27 cytological laboratories in Sweden were asked to rereview the slides, and all of them completed the rereview. One thousand nine hundred fifteen slides were retrieved and reviewed. Abnormalities were found in 30% of the slides, and the proportion of slides that had a changed diagnosis on rereview increased on average by 3.9% per sampling year during 2001–2016 (<i>p</i> &#x3c; 0.03). We also asked for rereview of normal smears taken up to 42 months before a histopathologically diagnosed high-grade squamous intraepithelial lesion (HSIL) or adenocarcinoma in situ (AIS). 19/27 laboratories responded, and out of 6,101 normal smears taken before HSIL/AIS, 5,918 were retrieved and rereviewed. The diagnosis was changed in 25% of cases. In summary, we found an increasing time trend of false-negative smears taken before invasive cervical cancer. This indicates a decreased protection of normal cytology in the screening program supporting earlier findings that this is the main reason behind the recent Swedish increase in cervical cancer. We suggest that optimal cervical cancer control may be promoted by routine nationally coordinated rereview of negative smears before high-grade cervical lesions or invasive cervical cancer.

scholarly journals Introduction of Radiotherapy in Suriname: Impact on the Treatment of Cervical Cancer

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 49s-49s
Author(s):  
E.T.M. Dams ◽  
W.B. Hawkins ◽  
M.Y. Lichtveld
Keyword(s):  
Cervical Cancer ◽  
Conflicts Of Interest ◽  
Invasive Cervical Cancer ◽  
Incidence Rates ◽  
Female Population ◽  
Stage Disease ◽  
Incidence And Mortality ◽  
Important Health ◽  
Detection Strategies

Abstract 7 Background: Cervical cancer is the second most frequent cancer and is the leading cause of cancer-related death in Surinamese women. Radiotherapy is an essential part of treatment, but until recently was not available in Suriname. Previously, affected women were treated abroad. This study evaluated the effect of the introduction of radiotherapy in 2012 on treatment coverage and quality of care. Methods: A retrospective cohort study was conducted, comparing treatment of women diagnosed with cervical cancer in the period 2008-2011, prior to introduction of radiotherapy, to treatment of women diagnosed in the period 2012-2013, who received radiotherapy locally. Results: During the study period January 2008–December 2013, 339 women received a first diagnosis of cervical cancer, corresponding to an average annual incidence rate of 21.3 ± 1.7 per 100,000 female population, with no significant changes during the study period. More than 80% of the women presented with late-stage disease. Creoles and indigenous women showed much higher incidence rates than the other ethnic groups. The proportion of women receiving appropriate radiotherapy increased from 71.6% in the period 2008-2011 to 82.4% in 2012-2013. The waiting time between diagnosis and treatment diminished with 38 days on average. In addition, the percentage women with a delay of >150 days decreased from 29% to 7%. Conclusion: Cervical cancer continues to pose an important health problem for women in Suriname. The introduction of radiotherapy has demonstrated improved treatment of invasive cervical cancer. However, additional prevention and early detection strategies are needed to lower incidence and mortality rates. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

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.

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.

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