A roadmap for a comprehensive control of cervical cancer in Poland: integration of available solutions into current practice in primary and secondary prevention
| Autor: | Maciej Krzakowski, Włodzimierz Olszewski, Paulina Wieszczy, Ernest Kuchar, Jan Walewski, Marc Arbyn, Joanna Didkowska, Mirosław Wielgoś, Andrzej Nowakowski, Kinga Miłosz, Michal F. Kaminski, Mariusz Bidziński, Maryla H. Turkot |
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| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
medicine.medical_specialty Quality Assurance Health Care cervical cancer Epidemiology primary prevention Control (management) Population Psychological intervention MEDLINE Uterine Cervical Neoplasms Legislation Cervix Uteri Alphapapillomavirus Mass Vaccination Review Article: Nervous System Cancer 03 medical and health sciences 0302 clinical medicine Secondary Prevention Humans Mass Screening Medicine liquid-based cytology Papillomavirus Vaccines 030212 general & internal medicine education Early Detection of Cancer Cervical cancer Secondary prevention education.field_of_study business.industry Incidence Papillomavirus Infections Public Health Environmental and Occupational Health medicine.disease 3. Good health human papillomavirus vaccines Oncology cancer screening 030220 oncology & carcinogenesis Family medicine DNA Viral Insurance Health Reimbursement Pap smear Female Poland business Quality assurance human papillomavirus testing |
| Zdroj: | European Journal of Cancer Prevention |
| ISSN: | 0959-8278 |
| Popis: | In Poland, cervical cancer incidence and mortality still remain considerably higher than in Western European countries or North America. Recent data indicate decreasing trends in women younger than 60 years and stable trends in older women. In this article, we identified obstacles in primary and secondary prevention of cervical cancer in Poland. We analysed local legislation, management structure and organization of cervical cancer prevention in Poland and reviewed solutions available and implemented in other European countries. The main weaknesses include: (i) very low coverage of organized screening; concurrent unregistered opportunistic screening with unknown coverage and high test consumption (ii) suboptimal quality assurance in organized screening and no external quality assurance in opportunistic screening (iii) very low coverage of human papillomavirus vaccination that is not centrally reimbursed (iv) absence of pilot evaluation of (a) interventions that may improve population coverage and (b) performance of new preventive strategies. The proposed solutions are multifaceted and involve: (i) legislative and organizational regulation of cervical cancer screening aimed at comprehensive registration of procedures, data access and quality assurance (ii) pilot testing and implementation of new ways to increase coverage of cervical cancer screening, in particular among older women (iii) pilot evaluation with possible introduction of human papillomavirus-based screening and (iv) inclusion of human papillomavirus vaccination into the reimbursed national immunization program. |
| Databáze: | OpenAIRE |
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