The role of cytomorphological studies in screening cervical cancer in the Republic of Tajikistan

Abstract

Introduction. Currently, in developed countries, virological screening is used as the main screening tool, and the Papanicolaou cytological control service is used as an auxiliary one. For countries with limited financial resources, WHO has recommended various options for an imaging screening strategy called «screening, diagnosis and treatment». Aim. The choice of the optimal model for the use of cytological studies, economically justified for our country, against the background of the expanding population-based visual screening of cervical cancer. Material and methods. The data of official statistics and the results of the pilot design of the WHO screening and treatment strategy in the Kushoniyon district of the Khatlon region and B. Gafurov district of the Sughd region were used. Results. As this study has shown, over the past decades in the Republic of Tajikistan, cytological screening for cervical cancer has fallen into complete decline and in recent years provides only 4.73% of women of reproductive age. Cytological examinations of cervical smears in the country are performed only as an additional test in cases of suspected cervical intraepithelial neoplasia. Due to the existing economic problems in the country, since 2016, the visual screening recommended by WHO for countries with limited resources has been introduced in a pilot way. The first results of the pilot implementation of visual screening have shown its high efficiency at a low economic cost. However, the question of the role of cytological studies against the background of coverage of the population with visual screening remains unclear. The economic feasibility and scale of the reorganization of cytomorphological support for cervical cancer screening in the Republic of Tajikistan was confirmed. Conclusions. In the conditions of the Republic of Tajikistan, as a result of the widespread coverage of the population with visual screening, Papanicolaou cytological studies will serve as an auxiliary tool and can be reorganized on the basis of the Republican Cancer Research Center and its regional and interdistrict divisions.

Perspectives of the prevention of cervical cancer in the Republic of Tajikistan

“…Выбор оптимального метода, обеспечивающий равный доступ для всех, эффективность и финансовая приемлемость являются основными критериями для выбора оптимального скрининга. Изучение опыта других развивающихся стран, и в соответствии с последниими рекомендациями ВОЗ, система здравоохранения пошла по пути применения организованного визуального скрининга среди целевых групп женщин в отобранных пилотных районах [2].…”

“…В 2016 г. МЗиСЗН на основе проведенной оценки ситуации по профилактике РШМ [2], одобрило алгоритм проведения организованного визуального скрининга среди женщин целевых групп (возраст 30-59 лет) в двух пилотных районах. Пилотные районы были отобраны на основе численности и плотности населения, высокой частоты заболеваемости и смертности женщин от РШМ.…”

“…Согласно официальным демографическим данным [2,5] в целевые группы обоих районов были включены 72574 женщин, из которых после проведения коммуникационно-информационных компаний в скрининге приняли участие 68391 женщин, общий охват скринингом составил 94,2%.…”