Cervical cancer screening in estonia present situation
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Cervical cancer screening in Estonia: present situation. Piret Veerus Department of Epidemiology and Biostatistics National Institute for Health Development Tallinn, Estonia. Cervical cancer in Estonia. ASIR (W) of cervical cancer 14.1 per 100,000 women yrs in 2003

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Cervical cancer screening in Estonia: present situation

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Cervical cancer screening in Estonia: present situation

Piret Veerus

Department of Epidemiology and Biostatistics

National Institute for Health Development

Tallinn, Estonia


Cervical cancer in Estonia

  • ASIR (W) of cervical cancer 14.1 per 100,000 women yrs in 2003

  • In 2003, 143 new cervical cancer cases detected

  • Among the female population, the 6th most common cancer site

  • In the age-group from 20 to 49 yrs the incidence rates almost doubled from 1980-82 to 1998-2000


Age-specific incidence of cervical cancer in Estonia, 1980-2000

Estonian Cancer Registry 2003


Mortality from cervical cancer in Northern Europe in 2000

Ferlay et al. GLOBOCAN 2002


Cervical cancer screening in Estonia

  • Around 140,000 Pap-tests performed yearly during daily medical practice in Estonia

  • Opportunistic cervical cancer screening started in 2003 in three regions

  • The Estonian Health Insurance Fund mailed invitations to a random sample of female population aged 30 to 40 yrs

  • Only 21.7% of the 12,960 invited women attended the screening, in 7% the results was abnormal


Cervical cancer screening in Estonia

  • Since 2004, all Estonian regions were included

  • Target group in 2004 and 2005 women aged 35 to 40 years and being insured

  • Women invited to cervical cancer screening tests via media

  • In 2004, 5264 women attended, 6% abnormal test

  • In 2005, 6552 women attended, 6% abnormal results


New Cancer Strategy

  • Presented to the Ministry of Social Affairs in 2005

  • Includes the needs, structure, methodology and budget forecast for cancer screening programmes in Estonia

  • Inludes the need for establishment of a screening registry and reference laboratory

  • Screening should cover the whole population, not only insured persons


Cervical cancer screening in Estonia since 2006

  • Target group for cervical cancer screening women aged 30 to 59 yrs

  • Screening interval 5 yrs after a negative result

  • Pathological results handled according to clinical guidelines

  • Funding for the screening registry, reference laboratory and non-insured women needed


Cervical cancer screening in Estonia since 2006

  • In 2006, personal invitations mailed to birth cohorts 1951, 1956, 1961, 1966, 1971

  • Trained midwives take Pap-smears at 19 clinics, tests performed at 7 labs

  • In the first 3 months of 2006, 57% (n=2305) of the invited women participated in cervical cancer screening


Planned action in the framework of Eurochip-2

  • Comparative study on coverage of the female population by Pap-tests and numbers of primarily detected cervical cancer cases before and after introducing the nationwide screening programme

  • Primary outcome measure: proportion of the female population covered by Pap-tests in 5-year age groups in different regions

  • Secondary outcome measure: proportion of primarily detected cervical cancer cases in different cancer stages


Data collection

  • Data about numbers of women in different age groups in each region from the Estonian Population Registry

  • Data about performed Pap-tests from the Estonian Health Insurance Fund

  • Data about results of Pap-tests from the screening programme

  • Data about primarily detected cervical cancer cases from the Estonian Cancer Registry


Thank You!


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