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Predicted Burden of Cervical Cancer With vs Without Effective Screening in Baltic, Central, and Eastern European Countries

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Key Points

  • Gradual implementation of effective screening programs would result in the prevention of 50% to 60% of preventable cases of cervical cancer in six Baltic, central, and eastern European countries by 2040.
  • The estimated number of cases of cervical cancer that would be prevented is approximately 180,000.

Vaccarella et al estimated changes in the incidence of cervical cancer through 2040 in six Baltic, central, and eastern European (BCEE) countries on the hypotheses of continued absence of effective screening programs vs progressive implementation of such programs. Their findings were reported in The Lancet Oncology.

Study Details

In the population-based study, incidence data from Estonia, Latvia, Lithuania, Belarus, Bulgaria, and Russia were analyzed (using age-period-cohort models with spline functions within a Bayesian framework) to project the future incidence from 2017 to 2040 based on the scenarios of continued absence of screening (scenario A) vs progressive introduction of effective screening beginning in 2017 (scenario B). Scenario B modeled the effect of gradual introduction of screening in each country based on the effect observed in Denmark, as comparator country, with the progressive introduction of screening from the late 1960s.

Effect of Screening

Estimated age-standardized incidence rates per 100,000 women for 2003 to 2007 were 35.4 for Estonia, 45.6 for Lithuania, 26.8 for Latvia, 26.1 for Belarus, 44.2 for Bulgaria, and 25.2 for Russia. With introduction of screening (scenario B), the preventive effects of effective screening would increase progressively over time, resulting in a 50% to 60% reduction in the projected incidence of cervical cancer by 2040. For no screening (scenario A) vs scenario B, estimated incidence rates/100,000 for 2036 to 2040 were 64.4 vs 31.4 for Estonia, 87.5 vs 43.4 for Lithuania, 68.4 vs 30.1 for Latvia, 67.2 vs 30.6 for Belarus, 55.1 vs 27.8 for Bulgaria, and 50.2 vs 23.3 for Russia. Overall, the estimated percentages of prevented cases by 2040 for screening starting in 2017 vs no screening were 30% for Estonia and Lithuania, 36% for Latvia, 35% for Belarus, 28% for Bulgaria, and 33% for Russia—representing an estimated total number of 179,899 cases prevented.

The investigators concluded: “Based on our findings, there is a clear need to begin cervical screening in these six countries as soon as possible to reduce the high and increasing incidence of cervical cancer over the next decades.”

Salvatore Vaccarella, PhD, of the International Agency for Research on Cancer, Lyon, is the corresponding author of The Lancet Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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