Cervical Cancer Prevention in the Era of the COVID-19 Pandemic

Abstract

Background and Objectives: Cervical cancer (CC) is the fourth most common cause of cancer-related morbidity and mortality among women worldwide. CC prevention is based on screening and HPV vaccination. The COVID-19 pandemic has caused difficulties in implementing CC-preventative measures. The aim of this study was to collect data on the implementation of CC prophylaxis in Poland provided by public and private health care with a particular focus on the impact of the COVID-19 pandemic and attempt to estimate the level of CC-screening implementation by 2026 under public and private health care. Materials and Methods: Data on the implementation of privately funded (2016–2021) and publicly funded (2014–2021) CC-preventative measures in Poland were examined. The Prophet algorithm, which positions itself as an automatic forecasting procedure and represents a local Bayesian structural time-series model, was used to predict data. The correlation test statistic was based on Pearson’s product moment correlation coefficient and follows a t distribution. An asymptotic confidence interval was given based on Fisher’s Z transform. Results: In 2021, a significantly higher population screening coverage was observed in private health care (71.91%) than in the public system (12.6%). Our estimation assumes that the adverse downward trend of population coverage (pap smear CC screening) in the public system will continue to 5.02% and in the private health system to 67.92% in 2026. Correlation analysis showed that with the increase in the sum of HPV tests and LBC, the percentage of Pap smear coverage in the private healthcare sector decreases r = −0.62, p = 0.260 df = 3, CI = [−0.97, 0.57]. The amount of HPV vaccinations provided in private health care is steadily increasing. Immunization coverage of the population of girls aged 9–18 years under private health care at the end of the observation period was 4.3% (2021). Conclusions: It is necessary to reorganize the public CC-screening system in Poland based on a uniform reporting system for tests performed in both public and private health care using the model of action proposed by us. We recommend the introduction of a national free HPV vaccination program funded by the government and implemented in public and private health care facilities.

Impactos da pandemia de COVID-19 no exame citopatológico do colo uterino no Pará

“…Contudo, os exames de CO não foram totalmente interrompidos, visto que, segundo a literatura, as pacientes que já apresentavam lesão com malignidade não tiveram o atendimento afetado (Sasidharanpillai & Ravishankar, 2022), portanto, apesar da diminuição dos exames, ainda houve seguimento dessas pacientes. Entretanto, a redução do rastreio é um fator predisponente para o aumento de lesões pré-malignas sem diagnóstico precoce, prejudicando o tratamento e o prognóstico dessas pacientes (Poniewierza & Panek, 2022). Somado a isso, apesar do retorno gradual da realização da CO, devido à demora no que concerne ao seu resultado e à persistência do medo de se expor à infecção pelo SARS-CoV-2, houve baixa procura das mulheres ao exame durante a pandemia (Costa et al, 2021).…”

Assessment of the impact of the COVID-19 pandemic on the level of health care services in Poland - a review

“…Odnaleziono 4 badania oceniające wpływ pandemii COVID-19 na poziom realizacji świadczeń zdrowotnych dotyczących programów profilaktycznych lub badań kontrolnych [24][25][26][27]. Wszystkie te prace miały zasięg ogólnopolski.…”

“…W przypadku wszystkich ocenianych programów profilaktycznych wykazano negatywny wpływ pandemii COVID-19 na poziom realizacji świadczeń co najmniej w wybranych okresach obserwacji lub dla wybranych obszarów systemu. W przypadku programu profilaktyki raka szyjki macicy stwierdzono, że w okresie pandemii liczba badań skriningowych znacznie się zmniejszyła (spadki obserwowane były również w latach wcześniejszych), jednak tylko w placówkach finansowanych przez NFZ [24]. W przypadku programu powszechnych przesiewowych badań słuchu u noworodków w 2020 roku doszło do znacznego pogorszenia dostępu do świadczeń ze względu na czasowe zawieszenie działalności 67% ośrodków prowadzących diagnostykę audiologiczną oraz funkcjonowanie pozostałych placówek w szczególnym reżimie sanitarno-epidemiologicznym.…”

Differences of characteristics, influencing factors, and treatment effects on the survival in patients with first and second primary cervical cancer

“…Cervical cancer (CC) ranks as the fourth most common cancer among women and is a leading cause of cancer-specific mortality among women worldwide ( Rahangdale et al, 2022 , Ran et al, 2022 ). In 2020, 604,000 new CC cases were diagnosed, and resulted in 342,000 deaths in women globally ( Poniewierza and Panek, 2022 ). After treatment, the survival rate of CC patients is significantly increased ( Siegel et al, 2019 ).…”