Cervix cancer screening in Croatia within the European cervical cancer prevention week [Probir raka vrata meternice u Hrvatskoj tijekom Europskog tjedna prevencije raka vrata maternice]

Škopljanac-Mačina, Lada and Mahovlić, Vesna and Ovanin-Rakić, Ana and Barišić, Ana and Rajhvajn, Sanda and Jurič, Danijela and Babić, Damir and Ćorušić, Ante and Orešković, Slavko (2010) Cervix cancer screening in Croatia within the European cervical cancer prevention week [Probir raka vrata meternice u Hrvatskoj tijekom Europskog tjedna prevencije raka vrata maternice]. Collegium Antropologicum, 34 (2). pp. 613-617. ISSN 0350-6134

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Abstract

Croatia still has opportunistic screening and the organized national screening has been planned. The European Cervical Cancer Prevention Week was held twice in Croatia, in January 2008 and 2009. Within the first one in 2008, information campaign "For All Women" via mass media was held, and women were invited to the organized free gynecological examination and Papanicolaou test (Pap test) in the University Department of Gynecology and Obstetrics, Zagreb University Hospital Center. Following invitation 481 women attended the testing; the median age was 55 years. There were more women aged > or = 50 (n = 353), with the highest participation in the age group 55-59 years (n = 94). Some women came because of subjective symptoms (n = 10), but the majority of them came only for testing (n = 471). According to history of previous cytological testing, 400 women have had > or = 1 negative findings, 71 women have had > or = 1 positive findings, 9 women attended Pap test for the first time, and 1 woman does not know about previous testing. Cervical cytology was abnormal in 35 women (7.28%), the median age was 42 years with the highest proportion in the age group 30-34 years (n = 7); among all of them 21 women (60%) had no abnormal Pap test previously. The findings were: Atypical squamous cells of undetermined significance--ASC-US (n = 9), ASC cannot exclude high-grade squamous intraepithelial lesion--ASC-H (n = 1), cervical intraepithelial neoplasia--CIN 1 (n = 13), CIN 2 (n = 1), CIN 3 (n = 6), carcinoma planocellulare (n = 2), atypical glandular cells--AGC-favor reactive endocervical cells (n = 3). Among women aged < or = 49 there were 20.47% abnormal findings and among those aged > or = 50, 2.55%. According to 21 positive Pap tests previously, among women aged < or = 49 there were 30.71% while among those aged > or = 50 there were 9.07%. Within the European Cervical Cancer Prevention Week in 2009, employed women from one national company were invited by internal information to the same procedure. A smaller group of younger asymptomatic women came for testing (n = 53), median age 39 years. According to history of previous cytological testing, 50 women have had > or = 1 negative findings, 3 women have had > or = 1 positive findings. In this study, Pap test was positive in 3.77% (n = 2). National screening programme should be focused on the participation of all personally invited women, especially younger age groups and under-screened women. Well designed information campaign should be implemented in national screening programme.

Abstract in Croatian

Hrvatska još uvijek ima oportunistički probir raka vrata maternice, premda se unazad nekoliko godina planira organizirani nacionalni probir. Europski tjedan prevencije raka vrata maternice održao se dva puta u Hrvatskoj, u siječnju 2008. i 2009. godine. Tijekom prvoga od njih provela se promidžbena akcija »Za sve žene« putem masovnih medija, te su žene bile pozvane na organizirani besplatni ginekološki pregled i Papa test u Klinici za ženske bolesti i porode Kliničkog bolničkog centra Zagreb. Nakon poziva došla je 481 žena srednje dobi 55 godina. Bilo je više žena dobi > ili = 50 (n=353), s najvećim udjelom u dobnoj skupini 55–59 godina (n=94). Neke žene su došle zbog subjektivnih simptoma (n=10), a većina je došla zbog preventivnog pregleda i Papanicolaou (Papa) testa (n=471). S obzirom na prethodnu citološku anamnezu, 400 žena imalo je > ili = 1 negativan citološki nalaz, 71 je imala > ili = 1 pozitivni citološki nalaz, 9 ih je prvi put pristupilo Papa testu, a 1 žena ne zna. Citološki nalaz bio je pozitivan u 35 žena (7,28%), srednje dobi 42 godine, s najvećim udjelom u dobnoj skupini 30–34 godine (n=7). Abnormalni citološki nalazi bili su: atipične pločaste stanice neodređenoga značenja – engl. ASC-US (n=9), atipične pločaste stanice – ne može se isključiti skvamozna intraepitelna lezija visokog stupnja – engl. ASC-H (n=1), cervikalna intraepitelna neoplazija CIN 1 (n=13), CIN 2 (n=1), CIN 3 (n=6), Carcinoma planocellulare (n=2), atipične glandularne stanice (engl. AGC) – endocervikalne, vjerojatno reaktivne promjene (n=3). Među ženama dobi < ili = 49 godina bilo je 20,47%, odnosno u dobi > ili = 50 godina 2,55% abnormalnih citoloških nalaza. Međutim kod žena dobi < ili = 49 godina bilo je 30,71% s prethodno > ili = 1 pozitivnim citološkim nalazom, a u skupini dobi > ili = 50 godina bilo ih je 9,07%. Tijekom Europskog tjedna prevencije raka vrata maternice 2009. godine poziv je upućen internom obavijesti ženama zaposlenima u jednoj nacionalnoj kompaniji. Došla je manja grupa mlađih žena (n=53), srednje dobi 39 godina. Sve su bile asimptomatske, a abnormalni Papa test nađen je u 3,77% (n=2). Nacionalni program probira mora se usmjeriti na odaziv svih osobno pozvanih žena, osobito mlađih dobnih skupina i nedovoljno skriniranih žena. Promidžbena akcija mora se aktivno provoditi u sklopu nacionalnog programa probira.

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