REVIEW PAPER
Effectiveness of the National Population-Based Cervical Cancer Screening Programme in Poland – Outcomes, problems and possible solutions 7 years after implementation
 
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Department of Gynaecologic Oncology, Poznan University of Medical Sciences, Poland
 
Ann Agric Environ Med. 2013;20(4):859–864
KEYWORDS
ABSTRACT
Cervical cancer is a substantial issue for public health in Poland. In 2006, in order to improve epidemiological data, the National Population-Based Cervical Cancer Screening Programme was developed and implemented. The Programme concerned 9.7 million women aged 25–59 to be screened during a 3-year interval. In 2010, a decline in cervical cancer incidence by 5.7% and 3.4% in mortality rate was observed. However, 5-year survival rates do not exceed 51%. Attendance rate reached 27%, then fell and presently remains on the level of 24%. Currently, the main concern for the screening organizers is searching for areas malfunctioning in local conditions, to improve them, and to provide further progress in cervical cancer prevention. The objective of the presented study was to critically review available data concerning the outcomes of the Screening Program and to suggest possible solutions. Two main factors were taken into account in the study: cost-effectiveness and attendance rate. To encourage attendance, women in Poland are sent personal invitations. This procedure consumes from a quarter up to a half of the budget of the Programme each year, but its effectiveness seems unsatisfactory. In addition to mailing, intensive training of doctors and midwives is conducted. Other activities to increase coverage include developing a social educational campaign. According to the Polish experience, the most effective way to increase coverage is training screening providers and involving them actively in encouraging screening participation. Thus, redistribution of funds from mailing to education and to a social campaign should be considered. Further development of cervical cancer prevention may depend on organizational changes including enhancing reporting, monitoring and quality control in opportunistic screening.
 
REFERENCES (29)
1.
GLOBOCAN 2008, IARC, http://globocan.iarc.fr/factsh....
 
2.
Krajowy Rejestr Nowotworów. [National Cancer Registry]. Centrum Onkologii – Instytut im.Marii Skłodowskiej-Curie. Zakład Epidemiologii i Prewencji Nowotworów, http://epid.coi.waw.pl/krn/ (access: 2013.01.29).
 
3.
Narodowy program zwalczania chorób nowotworowych. http://www. mz.gov.pl/wwwmz/index?mr=m16&m... &ma=04806.
 
4.
Bojar I, Cvejić R, Głowacka MD, Koprowicz A, Humeniuk E, Owoc A. Morbidity and mortality due to cervical cancer in Poland after introduction of the Act- National Programme for Control of Cancerous Diseases. AAEM 2012; 19(4): 680–685.
 
5.
Management of abnormal PAP smear – consensus guidelines of the National Cervical Cancer Screening Programme in Poland Coordinating Centre, the Polish Gynaecologic Society, the Polish Society of Pathologists and the Polish Society of Colposcopy and Uterine Cervix Pathology. Ginekol Pol 2009; 80(2):129–133.
 
6.
Postępowanie w przypadku stwierdzenia śródnabłonkowej neoplazji i raka gruczołowego in situ szyjki macicy. Rekomendacje Polskiego Towarzystwa Ginekologicznego, Polskiego Towarzystwa Patologów i Centralnego Ośrodka Koordynującego Populacyjny Program Profilaktyki i Wczesnego Wykrywania Raka Szyjki Macicy. Ginekol Pol. 2009; 80, 791–794.
 
7.
Verdecchia A, Francisci S, Brenner H, Gatta G, Micheli A, Mangone L, et al. Recent cancer survival in Europe: a 2000–02 period analysis of EUROCARE-4 data. Lancet Oncol. 2007; 8(7): 784–796.
 
8.
Wojciechowska U, Didkowska J, Zatoński W. Nowotwory złośliwe w Polsce – wskaźniki 5-letnich przeżyć według województw. Centrum Onkologii Instytut. Warszawa 2010.
 
9.
The National Cancer Registry Ireland. Cancer Trends No 12. Cancers of the cervix and uterus. January 2012. http://www.ncri.ie/pubs/pubfil... Cervix-Uterus%20(2).pdf (access: 2013.02.18).
 
10.
GUS. Central Statistical Office. Health and healthcare in 2011. Warszawa 2012. http://www.stat.gov.pl/cps/rde... zdrowia_w_2011.pdf.
 
11.
GUS. Stan Zdrowia Ludności Polski w przekroju terytorialnym w 2004 roku. Warszawa 2007. http://www.stat.gov.pl/cps/rde... stan_zdrowia_2004_teryt.pdf.
 
12.
Spaczyński M, Nowak-Markwitz E, Januszek-Michalecka L, KarowiczBilińska A. Profil socjalny kobiet a ich udział w Programie Profilaktyki i Wczesnego Wykrywania Raka Szyjki Macicy w Polsce. [Women’s social conditions and their participation in Cervical Cancer Population Screening Program in Poland]. Ginekol Pol. 2009; 80: 833–838.
 
13.
Spaczyński M, Karowicz-Bilinska A, Rokita W, Molińska-Glura M, Januszek-Michalecka L, Seroczyński P, et al. Uczestnictwo kobiet w Populacyjnym Programie Profilaktyki i Wczesnego Wykrywania Raka Szyjki Macicy w latach 2007–2009. [Attendance rate in the Polish Cervical Cancer Screening Program in the years 2007–2009]. Ginekol Pol. 2010; 81: 655–663.
 
14.
Raport COK. Populacyjny Program Profilaktyki i Wczesnego Wykrywania Raka Szyjki Macicy. Ginekol Pol. 2009; 80: 220–226.
 
15.
IARC Handbooks of Cancer Prevention; 10. Cervix cancer screening. IARC Press, Lyon, 2005.
 
16.
Anttila A, von Karsa L, Aasmaa A, Fender M, Patnick J, Rebolj M, et al. Cervical cancer screening policies and coverage in Europe. Eur J Cancer. 2009; 45(15): 2649–2658.
 
17.
OECD (2012), Health at a Glance: Europe 2012, OECD Publishing. http://dx.doi.org/10.1787/9789....
 
18.
Patnick J, Lancucki L. Cervical cancer screening programme in United Kingdom-England. In: Description of the national situation of cervical cancer screening in the member states of the European Union. Eur J Cancer. 2009; 45(15): 2703.
 
19.
Quinn M, Babb P, Jones J, Allen E. Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics. BMJ.1999; 318(7188): 904–8.
 
20.
Sasieni P, Cuzick J, Farmery E. Accelerated decline in cervical cancer mortality in England and Wales. Lancet. 1995; 346(8989): 1566–1567.
 
21.
Spaczyński M, Karowicz-Bilinska A, Kędzia W, Molińska-Glura M, Seroczyński P, Januszek-Michalecka L, et al. Koszty funkcjonowania polskiego Populacyjnego Programu Profilaktyki i Wczesnego Wykrywania Raka Szyjki Macicy w latach 2007–2009. [Costs of Population Cervical Cancer Screening Program in Poland between 2007–2009]. Ginekol Pol. 2010; 81: 750–756.
 
22.
de Sanjosé S, Bosch FX, Muñoz N, Shah K. Social differences in sexual behaviour and cervical cancer. IARC Sci Publ.1997; (138): 309–17. http:// www.ncbi.nlm.nih.gov/pubmed/93....
 
23.
Nanda K, McCrory DC, Myers ER, Bastian LA, Hasselblad V, Hickey JD, et al. Accuracy of the Papanicolaou test in screening for and followup of cervical cytologic abnormalities: a systemic review. Ann Intern Med.2000; 132(10): 810–9.
 
24.
Rokita W. Wartość diagnostyczna cytologii i kolposkopii u kobiet ze śródnabłonkową neoplazją szyjki macicy. [The diagnostic value of cytology and colposcopy in women with cervical intraepithelial neoplasia]. Ginekol Pol. 2011; 82, 607–611.
 
25.
Rokita W, Skawiński D, Zmelonek-Znamirowska A. Kędzia W, Karowicz-Bilińska A, Spaczyński R, et al. Wyniki badań cytologicznych i immunocytochemiczna identyfikacja białek p16 i Ki67 u kobiet ze śródnabłonkową neoplazją i rakiem szyjki macicy. [Results of pap smears and immunocytochemical detection of the p16 and Ki67 proteins in women with cervical intraepithelial neoplasia and cervical cancer]. Ginekol Pol. 2012; 83, 822–826.
 
26.
Rokita W, Kędzia W, Pruski D, Friebe Z, Nowak-Markwitz E, Spaczyński R, et al. Comparison of the effectiveness of cytodiagnostics, molecular identification of HPV HR and CINtecPLUSTM test to identify LG SIL and HG SIL. Ginekol Pol. 2012; 83, 894–898.
 
27.
Rokita W. Analiza wartości diagnostycznej wybranych testów molekularnych i immunocytochemicznych w wykrywaniu zmian patologicznych szyjki macicy. Wydawnictwo Naukowe Uniwersytetu Medycznego im. Karola Marcinkowskiego, 2011.
 
28.
Pruski D, Frąszczak J, Iwaniec K. Przybylski M, Kędzia W, GrętkiewiczTomczyk A, et al. Assessment of frequency of regression and progression of mild cervical neoplasia – LGSIL in women with positive high-risk HPV DNA test result. Ginekol Pol. 2012; 83, 572–575.
 
29.
Rekomendacje dotyczące aplikacji testów molekularnych identyfikujących DNA HPV HR w profilaktyce raka szyjki macicy. Stanowisko ekspertów PKD i KIDL. Ginekol Pol. 2013; 84: 396–400.
 
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ISSN:1232-1966