Cervical cancer screening
emergency in Europe
Uterine cancers are classified as:
- ICD 180: Cervical cancer
- ICD 182: Corpus uteri cancer
- ICD 179: Uterus cancers, not specified
On the basis of national death certificates, it
is not possible to analyze mortality from cervical cancer in Europe,
since 20-65% of deaths from uterine cancer in largest countries
are still certified as uterus, unspecified (Levi, EJC, 2000).
To estimate cervical cancer mortality we used death
rates for uterine cancers (ICD 179, 180, 182) in women aged 20-44
(see Figure 1), since most deaths from uterine cancer below the
age of 45 years arise from the cervix. This way, overall uterus
cancer mortality in young ages is a proxy for cervical cancer mortality.
In Western European countries was noticed a substantial
decrease in mortality rates. Among Eastern European countries was
observed a decrease of mortality in Poland, while rising trends
were noticed in Bulgaria, Latvia, Lithuania, and Romania. In these
countries it has been assessed about 2500 avoidable deaths in 2000.
An estimate of the number of avoidable deaths was
performed subtracting to the observed number of deaths the expected
number of deaths obtained applying to age-specific populations of
Romania, Bulgaria, Latvia and Lithuania (and other Eastern European
countries) the age-specific death rates of Norway, Finland and Italy.
Table 1 shows the number of avoidable deaths in 2000 for uterus
cancers in young ages (20-44). In other words, supposing that all
uterus cancer deaths in young ages were due to cervical cancer,
every year about 500-600 deaths in young women should be avoided
(if Romania, Bulgaria, Latvia and Lithuania should reach death rates
of countries with lowest mortality levels).
Lately society is growing to hold a new concept
of health. All members of society from all levels – institutions,
schools, families, citizens – feel more responsible for their
well-being. All become more acquainted with the scientific language
and can be more aware of the choices they take in relation to health.
Under this umbrella, EUROCHIP-2 organizes a “Task force on
cervical cancer screening emergency” against cervical cancer
mortality increasing trends in Eastern Europe in order to:
- analyze cervical cancer screening guidelines for Romania, Lithuania,
Bulgaria and Latvia;
- assess the possibility to (re-)organize cervical cancer screening
programs in those countries
- promote an action against increasing cervical cancer mortality
trends for the European Parliament
Moreover, EUROCHIP-2 will support personal in each
country to organize ad-hoc studies to assess cervical cancer screening
program. The main results of the work in each country should be:
- a report for Health Ministry in order to underline which are the
national problems for the evaluation of a cervical cancer screening
programme including also considerations on costs
- participation in the report of the task Force for the European
Parliament
- promote an important initiative able to emphasize the EU role
in public health. The outcome of cervical cancer screening programmes
is well known in terms of mortality reduction among women: it is
unacceptable that such a scientific information is not applied in
some EU countries.
EUROCHIP-II could organize ad-hoc studies to assess
the possibility to organize cervical cancer screening programmes.
In order to start the assessment activity in those countries we
suggest the manual produced by Alliance
for Cervical Cancer Prevention (ACCP).
Situation in various countries
1st meeting of the Task Force
| Country |
Cervical cancer screening
situation |
Task Force Discussion |
Summary |
| Bulgaria |
|
|
|
| Lithuania |
|
| Latvia |
|
| Romania |
|
| Estonia |
|
|
