Implementation of CxCa Screening program in Uzbekistan

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Working meeting on Comprehensive Cervical Cancer Prevention and Control in UNFPA EECARo and ASRO Countries Implementation of CxCa Screening program in UZbekistan

MAGNITUDE AND BURDEN OF CERVIVAL
CANCER IN UZBEKISTAN

Rationale for initiating national program for
cervical cancer and control

• Total morbidity rate due to cervical cancer -8,4 (per
100,000 population)
• Early detection at 0-1 stages -10%
• Cervical cancer cases detected at II-IV stages – 83% (MoH)

Health System Structure and entry points for
CxCa programs

• Health care system reforms started in 1998
and enabled integration of SRH at PHC level
• GPs and midwives are key in provision of SRH
services
National Ob/GYN Center
Cytology labs at regional
level (PAP tests (control and
interpretation) establishment of national
PHC clinics database)
(Smears collection,
transportation)
National Oncology Center
Oncology dispensaries at
(treatment and follow-up
regional level
care)

HEALTH SYSTEM STRENGTHENING APPROACH for CERVICAL
CANCER PREVENTION AND CONTROL

CHALLENGES ACTIONS TAKEN

•Low technical capacity of health care •UNFPA took a leadership in
system to apply secondary screening introduction of cytological screening
•Lack of financing to cover the needed (Pap test)
age cohort of female population by Pap •Small scale study on cost –benefit
screening analysis on implementing of a National
•National program to support CxCa Cancer Screening program is conducted
control and prevention is not in place •MoH is in charge to monitor and
yet ( at stage of pilot projects supported analyze the results of pilot projects
by donors) •Referral system is established for
•CxCa problem is still under priority of control and monitoring
specialized oncology services with low •Practical guidelines for PHC health care
sensitization on prevention and providers and lab technicians is
monitoring developed
•Only 25% of women in age 30-65 will
covered under pilot project by Pap test
in 5 pilot regions

Age groups to be covered and cost - benefit
analysis of implementation of Pap screening

Ways forward/ future plans

• Capacity building (trainings for lab specialists, Ob/Gyns and
midwives, including in-job trainings)
• Data base establishment and monitoring at regional and
national level within 5 regions
• Improvement technical capacity of PHC and specialized
clinics/labs through procurement of essential supplies for Pap
tests, colposcopy and LEEP
• Advocacy activities to develop sustainable mechanisms to
establish screening and control system nationwide

This document discusses comparing the efficacy of visual inspection with acetic acid (VIA) and pap smear as methods for cervical cancer screening in low resource settings. Cervical cancer is very common in Pakistan but there is no effective or affordable screening program. The objectives are to compare the sensitivity, specificity, and predictive values of VIA and pap smear, and to determine the prevalence of cervical abnormalities. VIA may be better for low resource areas as it is low cost, provides immediate results, and does not require follow up visits. The study aims to enroll women ages 25-60 to undergo both VIA and pap smear to evaluate which method is more effective for cervical cancer screening in Pakistan.

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