A MODERN VIEW ON THE CERVICAL CANCER SCREENING: UKRAINIAN AND GLOBAL EXPERIENCE

  • Natalia Volodko Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
Keywords: oncology, cervical cancer, prevention, screening, HIV

Abstract

One of the important medical problems consists in the prevalence and incidence of cervical cancer, implementation of innovative technologies in the diagnostics and treatment of this pathology.

Every six months, half a million women around the globe are taken ill by this disease, and 270 thousand women die of it. Undoubtedly, the major burden of this disease falls on developing countries. However, for economically developed countries with a well organized cervical screening, this problem remains topical too. In European countries, cervical screening allowed to significantly reduce the cervical cancer incidence in 80-90s of the previous century, for instance, in Great Britain, Sweden, and Finland. However, even in these countries, for the past 15-20 years, the number of women suffering from cervical cancer has not decreased. The main reason lies in epidemiological, social, and ecologic peculiarities of the modern world. If modern tendencies of cervical cancer incidence growth retain, then an annual number of people with cervical cancer may reach 1 million by 2050.

Based on the WHO assessment, there exist all prerequisites for cervical cancer elimination. Vaccination allows creating a sufficiently powerful collective immunity against HPV. There exist quite specific and sensitive methods for diagnostics and treatment of cervical precancer, which are being improved every year.  We are witnessing a change of diagnostic paradigm of cervical screening. The co-testing strategy came to replace the traditional PAP testing. Increased sensitivity and specificity of cytologic testing is achieved using the method of liquid-based cytology together with HPV testing. Initial HPV screening provides promising results, ensuring wide coverage of female population thanks to the possibility of independent sampling.

In Ukraine, cervical cancer incidence constituted 4,157 people in 2016-2017, while the death rate amounted to 1,757 women. The mortality rate up to one year constitutes 16.7%. It is worth noting that in 2017, the increase in cervical cancer incidence (21.5 against 20 per 100 thousand of the female population) and mortality (9 against 8.7 respectively) was recorded. Every day in Ukraine, 6 women die of this disease. And this happens despite the fact that we do have the infrastructure for opportunist cervical screening. Implementation of a new generation cervical screening will enable revolutionary HPV prevention, improved diagnostics, and treatment of cervical precancer.

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References

Cancer in Ukraine. National Cancer Registry. Kyiv 2017.

HPV Information Centre. Available online: [http://www.hpvcentre.net/].

Ministry of Health of Ukraine. Order No. 236 from 02.04.2014 On approval of standardization of medical care for dysplasia and cervical cancer.

Massad LS, Einstein MH, Huh WK, et al. 2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2013, 17(3): 367. https://doi.org/10.1097/LGT.0b013e3182976e64

World Health Organization. WHO Guidelines for Treatment of Cervical Intraepithelial Neoplasia 2–3 and Adenocarcinoma in situ: Cryotherapy, Large Loop Excision of the Transformation Zone, and Cold Knife Conization. Geneva. WHO (2014).

The National Health Service England. Colposcopy and programme management guidelines for the NHS cervical screening programme.

Available from: [https://assets.publishing.service.gov.uk/government/uploads/system/uploads/ attachment_data/file/515817/NHSCSP_colposcopy_management.pdf], last accessed Oct 31, 2018.

Tjalma W. The ideal cervical cancer screening recommendation for Belgium, an industrialised country in Europe. Belg J Med Oncol. 2014, 8(2): 44–51.

Einaudi, L, Boubli, L, Carcopino X. How are excisional therapies for CIN performed in France? A national audit. J Gynecologie Obstetrique Biologie Rep 2015, 44: 403–10. https://doi.org/10.1016/j.jgyn.2014.11.002

Petry KU, Breugelmans LG, Bénard S, et al. Cost of screening and treatment of cervical dyskaryosis in Germany. Eur J Gynaecol Oncol . 2008, 4: 345–9.

Balakireva OM, et al. The state and factors of health of Ukrainian adolescents as a result of sociological research within the framework of the international project Health behaviour school-aged children. Kyiv, 2011:172.

Available from: [http://www.uisr.org.ua/img/upload/files/HBSC/HBSC_Report_2011.pdf].

Balakireva OM, Ryngach NO, Levin RY, et al. Health behaviour school-aged children in Ukraine. Kyiv, 2007.

Public Health Center of the MOH of Ukraine. The epidemic situation with HIV in Ukraine as of 01.01.2018. Available from: [http://phc.org.ua/].

Petry KU, Nieminen PJ, Leeson SC, et al. 2017 update of the European Federation for Colposcopy (EFC) performance standards for the practice of colposcopy. European Journal of Obstetrics and Gyneacology and Reproductive Biology. 2017, 224: 137–41. https://doi.org/10.1016/j.ejogrb.2018.03.024

Ciavattini A, Serri M, Di Giuseppe J, et al. Reliability of colposcopy during pregnancy. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2018, 229:76–81. https://doi.org/10.1016/j.ejogrb.2018.07.029


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Published
2018-12-28
How to Cite
1.
Volodko N. A MODERN VIEW ON THE CERVICAL CANCER SCREENING: UKRAINIAN AND GLOBAL EXPERIENCE. Proc Shevchenko Sci Soc Med Sci [Internet]. 2018Dec.28 [cited 2022Jul.2];54(2):94-107. Available from: https://mspsss.org.ua/index.php/journal/article/view/164