Cervical Cancer Mortality in Romania: Trends, Regional and Rural–Urban Inequalities, and Policy Implications

Abstract

Background and Objectives: Despite being largely preventable, cervical cancer mortality still remains an important public health problem globally, in Europe, and in Romania. The European Union member states are urged to implement systematic, population-based screenings for cervical cancer, but the programs developed by the countries remain very heterogeneous. This study aimed to investigate the differences in cervix cancer mortality between Romania and EU and within Romania over the last two decades and to reveal the major sources of inequalities and the policy implications. Materials and Methods: We analyzed the number of deaths and the mortality rates by cervical cancer, standardized using the direct method, over two decades (2001–2016 for the EU, and 2001–2019 for the national and sub-national analyses). Trends, mortality reduction over the years, and mortality differences at the beginning and end of the time interval have been calculated for the EU and Romania, at national and sub-national levels (rural–urban and regions). Results: Our results revealed differences in cervical cancer mortality between Romania and EU and within Romania (among regions and rural–urban areas). These differences used to be very high in the past and are still persisting. Conclusions: The country should revisit its national cervical cancer screening program, which has been implemented for many years, but with a very limited participation rate. Due to the similar problems existing in Central-Eastern Europe, targeted support from the EU for the members from this geographical area could contribute to the minimization of differences in cervical cancer mortality among the EU members.

The Impact of SARS-CoV-2 Pandemic on Patients Undergoing Radiation Therapy for Advanced Cervical Cancer at a Romanian Academic Center: A Four-Year Retrospective Analysis

“…The trends in cervical cancer outcomes in Romania might generally follow a negative turn during and after the COVID-19 pandemic, as compared with the period before, described by Furtunescu et al [ 38 ]. Their 20-year epidemiological study indicated significant variations in cervical cancer death rates between Romania and the European Union, as well as within Romania.…”

The profile of cervical dysplasia and cervical cancer of patients at MRCCC siloam Hospital Semanggi

“…Cervical cancer was ranked 19th most new cancer cases in Europe. The death rate of cervical cancer was ranked number 19 for the most deaths due to cancer [5]. In Germany, Netherlands and USA cervical cancer are ranked respectively number 21, 22 and 21 as cancer cases and number 21, 21 and 19 as cancer that causing death [6;7;8].…”

The Accuracy of Cytology, Colposcopy and Pathology in Evaluating Precancerous Cervical Lesions

“…A recent report indicated the high reliability of novel droplet digital PCR in molecularly characterizing premalignant uterine cervical lesions by detecting viral DNA belonging to different HPV genotypes [ 5 ]. However, in Romania, many patients are still diagnosed with late-stage cervical cancer despite the consistent introduction of national health programs for early detection that have been implemented in recent years [ 6 , 7 ].…”

“…The present study aimed to evaluate (representing an internal audit) the performance of colposcopic examination in our unit by examining the correlation between cytology (Bethesda 2001 terminology [ 6 ]), colposcopic appraisal, and biopsy histology for the early detection of premalignant and malignant cervical lesions.…”