Breast and cervical cancer screening practices in nine countries of Eastern Europe and Central Asia: A population-based survey
Znaor A. Ryzhov A. Losada M.L. Carvalho A. Smelov V. Barchuk A. Valkov M. Ten E. Andreasyan D. Zhizhilashvili S. Dushimova Z. Zhuikova L.D. Egorova A. Yaumenenka A. Djanklich S. Tril O. Bray F. Corbex M.
December 2023Elsevier Ltd
Journal of Cancer Policy
2023#38
Background: Eastern Europe and Central Asia (EECA) countries have higher cervical and breast cancer mortality rates and later stage at diagnosis compared with the rest of WHO European Region. The aim was to explore current early detection practices including “dispensarization” for breast and cervix cancer in the region. Methods: A questionnaire survey on early detection practices for breast and cervix cancer was sent to collaborators in 11 countries, differentiating services in the primary health setting, and population-based programs. Responses were received from Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Russian Federation (Arkhangelsk, Samara and Tomsk regions), Tajikistan, Ukraine, and Uzbekistan. Results: All countries but Georgia, Kyrgyzstan, and the Russian Federation had opportunistic screening by clinical breast exam within “dispensarization” program. Mammography screening programs, commonly starting from age 40, were introduced or piloted in eight of nine countries, organized at national oncology or screening centres in Armenia, Belarus and Georgia, and within primary care in others. Six countries had “dispensarization” program for cervix cancer, mostly starting from the age 18, with smears stained either by Romanowsky-Giemsa alone (Belarus, Tajikistan and Ukraine), or alternating with Papanicolaou (Kazakhstan and the Russian Federation). In parallel, screening programs using Papanicolaou or HPV test were introduced in seven countries and organized within primary care. Conclusion: Our study documents that parallel screening systems for both breast and cervix cancers, as well as departures from evidence-based practices are widespread across the EECA. Within the framework of the WHO Initiatives, existing opportunistic screening should be replaced by population-based programs that include quality assurance and control.
Breast cancer , Central Asia , Cervix cancer , Eastern Europe , Screening
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International Agency for Research on Cancer, Lyon, France
Taras Shevchenko National University of Kyiv, Ukraine
World Health Organization Regional Office for Europe, Copenhagen, Denmark
Tampere University, Faculty of Social Sciences/Health Sciences, Tampere, Finland
Arkhangelsk Regional Oncology Centre, Northern State University, Arkhangelsk, Russian Federation
Scientific and Production Centre for Preventive medicine of the Ministry of Health, Bishkek, Kyrgyzstan
International Higher School of Medicine, IUK Academic Consortium, Bishkek, Kyrgyzstan
National Institute of Health, Ministry of Health, Yerevan, Armenia
Tbilisi State Medical University (TSMU), Tbilisi, Georgia
Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan
Tomsk Regional Oncology Centre, Russian Federation
Samara Regional Oncology Centre, Russian Federation
N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus
National Cancer Center of Uzbekistan, Tashkent, Uzbekistan
Cancer Regional Treatment and Diagnostics Centre, Lviv, Ukraine
International Agency for Research on Cancer
Taras Shevchenko National University of Kyiv
World Health Organization Regional Office for Europe
Tampere University
Arkhangelsk Regional Oncology Centre
Scientific and Production Centre for Preventive medicine of the Ministry of Health
International Higher School of Medicine
National Institute of Health
Tbilisi State Medical University (TSMU)
Kazakh Institute of Oncology and Radiology
Tomsk Regional Oncology Centre
Samara Regional Oncology Centre
N.N. Alexandrov National Cancer Centre of Belarus
National Cancer Center of Uzbekistan
Cancer Regional Treatment and Diagnostics Centre
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