Transcript Cervical cancer screening in Estonia: present situation

Cervical cancer screening
in Estonia: present situation
Piret Veerus
Department of Epidemiology and Biostatistics
National Institute for Health Development
Tallinn, Estonia
Cervical cancer in Estonia
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ASIR (W) of cervical cancer 14.1
per 100,000 women yrs in 2003
In 2003, 143 new cervical cancer
cases detected
Among the female population, the
6th most common cancer site
In the age-group from 20 to 49 yrs
the incidence rates almost doubled
from 1980-82 to 1998-2000
Age-specific incidence of cervical
cancer in Estonia, 1980-2000
Estonian Cancer Registry 2003
Mortality from cervical cancer in
Northern Europe in 2000
Ferlay et al. GLOBOCAN 2002
Cervical cancer screening in Estonia
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Around 140,000 Pap-tests performed
yearly during daily medical practice in
Estonia
Opportunistic cervical cancer screening
started in 2003 in three regions
The Estonian Health Insurance Fund
mailed invitations to a random sample of
female population aged 30 to 40 yrs
Only 21.7% of the 12,960 invited women
attended the screening, in 7% the results
was abnormal
Cervical cancer screening in Estonia
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Since 2004, all Estonian regions were
included
Target group in 2004 and 2005 women
aged 35 to 40 years and being insured
Women invited to cervical cancer
screening tests via media
In 2004, 5264 women attended, 6%
abnormal test
In 2005, 6552 women attended, 6%
abnormal results
New Cancer Strategy
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Presented to the Ministry of Social Affairs
in 2005
Includes the needs, structure,
methodology and budget forecast for
cancer screening programmes in Estonia
Inludes the need for establishment of a
screening registry and reference
laboratory
Screening should cover the whole
population, not only insured persons
Cervical cancer screening in
Estonia since 2006
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Target group for cervical cancer
screening women aged 30 to 59 yrs
Screening interval 5 yrs after a
negative result
Pathological results handled
according to clinical guidelines
Funding for the screening registry,
reference laboratory and noninsured women needed
Cervical cancer screening in
Estonia since 2006
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In 2006, personal invitations
mailed to birth cohorts 1951, 1956,
1961, 1966, 1971
Trained midwives take Pap-smears
at 19 clinics, tests performed at 7
labs
In the first 3 months of 2006, 57%
(n=2305) of the invited women
participated in cervical cancer
screening
Planned action in the framework of
Eurochip-2
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Comparative study on coverage of the
female population by Pap-tests and
numbers of primarily detected cervical
cancer cases before and after introducing
the nationwide screening programme
Primary outcome measure: proportion of
the female population covered by Paptests in 5-year age groups in different
regions
Secondary outcome measure: proportion
of primarily detected cervical cancer cases
in different cancer stages
Data collection
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Data about numbers of women in
different age groups in each region from
the Estonian Population Registry
Data about performed Pap-tests from the
Estonian Health Insurance Fund
Data about results of Pap-tests from the
screening programme
Data about primarily detected cervical
cancer cases from the Estonian Cancer
Registry
Thank You!