WORKING MEETING ON COMPREHENSIVE CERVICAL CANCER PREVENTION AND

CONTROL IN UNFPA EECARO AND ASRO COUNTRIES

Implementation of CxCa screening program in Uzbekistan

Antalya, Turkey 18-20 May 2011

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

PHC clinics

(Smears collection, transportation)

Cytology labs at regional level (PAP tests interpretation)

National Ob/GYN Center

(control and establishment of national

database)

Oncology dispensaries at regional level

National Oncology Center (treatment and follow-up

care)

CHALLENGES ACTIONS TAKEN

•Low technical capacity of health care system to apply secondary screening •Lack of financing to cover the needed age cohort of female population by Papscreening •National program to support CxCacontrol and prevention is not in place yet ( at stage of pilot projects supported by donors)•CxCa problem is still under priority of specialized oncology services with low sensitization on prevention and monitoring •Only 25% of women in age 30-65 will covered under pilot project by Pap test in 5 pilot regions

•UNFPA took a leadership in introduction of cytological screening (Pap test)•Small scale study on cost –benefit analysis on implementing of a National Cancer Screening program is conducted •MoH is in charge to monitor and analyze the results of pilot projects•Referral system is established for control and monitoring •Practical guidelines for PHC health care providers and lab technicians is developed

HEALTH SYSTEM STRENGTHENING APPROACH for CERVICAL CANCER PREVENTION AND CONTROL

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

Thank You!