Past, Present and Future of the Cervical Cancer Screening in Latvia

Abstract

Traditionally in Latvia, most women request gynecological services for preventive and health promotion reasons or in the case of having a gynecological disease. So the overloaded general practitioners and the lack of involvement of gynecologists are one of the main obstacles to solve for implementing an organized screening program in Latvia. Moreover insufficient availability of quality-assured services and resources for cytology testing and other services of the program, and for monitoring and evaluating the whole program, must be considered in the implementation of a comprehensive screening plan.t

Analysis of invasive cervical cancer cases in Latvia

“…Studies have shown that improperly collected cytological smears are in fault for false negative or false positive results. 6,7 In the current study, 42.9% (n=24) of invasive cervical cancer cases were detected in women who had had either annual visit to a gynecologist or visit once in a three years. For 32.2% (n=18) of patients to whom cancer was detected in late stage, the cytological examination interval was shorter than three years.…”

“…6,7 Frequency of false positive and false negative results is equal for both methods. 6 Thus, the cytological test result depends on quality of the material and qualification of the cytotechnologist. Studies have shown that improperly collected cytological smears are in fault for false negative or false positive results.…”

“…In Latvia, cervical cytological examination has been used since the 1960s. 6 Historically, the Leishman methodology is applied, while elsewhere in the world the Papanikolau method prevails. 6,7 Frequency of false positive and false negative results is equal for both methods.…”

“…6 Historically, the Leishman methodology is applied, while elsewhere in the world the Papanikolau method prevails. 6,7 Frequency of false positive and false negative results is equal for both methods. 6 Thus, the cytological test result depends on quality of the material and qualification of the cytotechnologist.…”

“…8 According to European guidelines for quality assurance in cervical cancer screening the laboratory should perform a minimum of 10,000 tests per year, in Latvia it could be at least 5,000 tests per year. 6,[8][9][10] Quality control measures such as annual testing of cytotechnologists, rescreening of random negative smears and analysis of individual screening and diagnostic smears in each case of invasive cervical cancer should be implemented. 6,[9][10][11] Though at the moment this is not possible because samples are not preserved in case of negative result.…”