The Burden of Cervical Cancer in South-East Europe at the Beginning of the 21st Century

The situation of cervical cancer prevention in South-East Europe is hardly documented, in spite of the fact that it encloses the most affected countries of Europe. We estimated the number of cases of cervical cancer, the number of deaths from this malignancy and the corresponding rates for 11 countries located in South-East Europe, in the period 2002–2004. Each year, approximately 9,000 women develop cervical cancer and about 4,600 die from the disease in this subcontinent. The most affected country is Romania with almost 3,500 cases and more than 2,000 deaths per year. High world-age standardised mortality rates (>7.5 [expressed per 100,000 women-years]) are observed in 7 countries: FYROM (7.6), Moldova (7.8), Bulgaria (8.0), Bosnia & Herzegovina (8.0), Albania (9.8), Serbia & Montenegro (10.1) and Romania (13.0). A matter of concern is the increasing mortality rate, in younger women, in the countries with the highest burden of cervical cancer. Thus, appropriate cervical cancer prevention programmes should be set up without delay in this part of Europe

European code against cancer 4th edition: 12 ways to reduce your cancer risk

This overview describes the principles of the 4th edition of the European Code against Cancer and provides an introduction to the 12 recommendations to reduce cancer risk. Among the 504.6 million inhabitants of the member states of the European Union (EU28), there are annually 2.64 million new cancer cases and 1.28 million deaths from cancer. It is estimated that this cancer burden could be reduced by up to one half if scientific knowledge on causes of cancer could be translated into successful prevention. The Code is a preventive tool aimed to reduce the cancer burden by informing people how to avoid or reduce carcinogenic exposures, adopt behaviours to reduce the cancer risk, or to participate in organised intervention programmes. The Code should also form a base to guide national health policies in cancer prevention. The 12 recommendations are: not smoking or using other tobacco products; avoiding second-hand smoke; being a healthy body weight; encouraging physical activity; having a healthy diet; limiting alcohol consumption, with not drinking alcohol being better for cancer prevention; avoiding too much exposure to ultraviolet radiation; avoiding cancer-causing agents at the workplace; reducing exposure to high levels of radon; encouraging breastfeeding; limiting the use of hormone replacement therapy; participating in organised vaccination programmes against hepatitis B for newborns and human papillomavirus for girls; and participating in organised screening programmes for bowel cancer, breast cancer, and cervical cancer

Cervical cancer assessment in Romania under EUROCHIP-2.

BACKGROUND: Inside the European project EUROCHIP-2, the Romania team has ruled out an assessment study regarding cervical cancer screening programs (CCS) in Romania, in Nov 2006-March 2007. The general purpose was to be aliened to European Council recommendations that states that an organized cervical screening program should be offered in all member states, in order to reduce the specific incidence and mortality. The aim of the study was to assess cervical cancer burden and current cervical cancer screening status in Romania and in various sub-regions (DR), and also to identify problems and barriers and to propose solutions for implementing an organized cervical cancer screening program at national level. METHODS: The study was based on a statistical survey and a comprehensive literature review of the most important European, national and regional papers or studies completed in this field. RESULTS: Over 2000-2006, a total number of 22,830 new cases and 12,763 deaths from cervical cancer was registered in Romania. In 2005, the crude rate of incidence varied largely in the 8 DR between 17.8-31.3 and mortality varied between 12.3-21.5. The proportion of women tested by DRs on total female population varied between 3.2%-0.6%; the highest screening activity was observed in region VI, where run the only organized CCS in Romania. In 2005, there were one GP per 578 female population aged 25-65; regarding the specialists in 2007 per country we had: 3,012 women aged 25-65 per one gynecologist, 21,195 women per one oncologist and 13,258 women per one histopathologist. DISCUSSION AND CONCLUSION: There were no major changes in policy screening over 2000-2006 correlated with no major difference in specific mortality in Romania. Significant differences in incidence and mortality between DRs were observed in 2005, which impose deeper analyzes of local conditions and resources and local strategies to be adopted. The burden of cervical cancer is particularly high in Romania and is related to the absence of an organized CCS program or the ineffectiveness of the opportunistic screening programs. It is needed that European Council recommendations be implemented and quality assurance strategies to be checked and maintained at all screening levels in Romania

Controversies about cervical cancer screening: A qualitative study of Roma women's (non)participation in cervical cancer screening in Romania

Romania has Europe's highest incidence and mortality of cervical cancer. While a free national cervical cancer-screening programme has been in operation since 2012, participation in the programme is low, particularly in minority populations. The aim of this study was to explore Roma women's (non)participation in the programme from women's own perspectives and those of healthcare providers and policy makers. We carried out fieldwork for a period of 125 days in 2015/16 involving 144 study participants in Cluj and Bucharest counties. Fieldwork entailed participant observation, qualitative interviewing and focus group discussions. A striking finding was that screening providers and Roma women had highly different takes on the national screening programme. We identified four fundamental questions about which there was considerable disagreement between them: whether a free national screening programme existed in the first place, whether Roma women were meant to be included in the programme if it did, whether Roma women wanted to take part in screening, and to what degree screening participation would really benefit women's health. On the background of insights from actor-network theory, the article discusses to what degree the programme could be said to speak to the interest of its intended Roma public, and considers the controversies in light of the literature on patient centred care and user involvement in health care. The paper contributes to the understanding of the health and health-related circumstances of the largest minority in Europe. It also problematizes the use of the concept of “barriers” in research into participation in cancer screening, and exemplifies how user involvement can potentially help transform and improve screening programmes

Current status and length–weight relation of the European mudminnow, Umbra krameri (Actinopterygii: Esociformes: Umbridae), from Jieț River, Dolj County, southwestern Romania

The habitat of the European mudminnow, Umbra krameri Walbaum, 1792, is continuously decreasing due to human intervention. The species has a “vulnerable” status according to the IUCN Red List. Thus, new information about the species is needed for conservation efforts. Minnow traps were used for capturing Umbra krameri and other small fishes in the Jieț River, Dolj County, southwestern Romania. Captured specimens of U. krameri were measured and weighed. Length–weight relations and relative condition factor were determined for the captured U. krameri specimens. A total of 94 fishes were captured using the minnow traps. They represented 7 species: European bitterling, Rhodeus amarus (Bloch, 1782), roach, Rutilus rutilus (Linnaeus, 1758), rudd, Scardinius erythrophthalmus (Linnaeus, 1758), Danubian spined loach, Cobitis elongatoides Băcescu et Mayer, 1969, weatherfish, Misgurnus fossilis (Linnaeus, 1758), tubenose goby, Proterorhinus marmoratus (Pallas, 1814), and U. krameri. The specimens of Umbra krameri represented 44% (41 specimens) of the total catch. The wet body weight (BW) of U. krameri ranged from 0.8 to 5.1 g, having a mean value of 2.102 g. The mean total length (TL) was 5.782 cm, ranging from 4.59 to 7.87 cm. According to the length–weight relation (LWR), the growth type of U. krameri was positive allometric based on the determined equation: BW = 0.0068TL3.277. The mean value determined for the relative condition factor (Kn) was 1.0056486. The growth condition of 46% of the specimens was poor (Kn < 1; n = 19), while the other 54% were in good condition (Kn ≥ 1; n = 22). The presently reported study provides information about the presence of U. krameri in the Jieț River (Dolj County, Romania), a location where the species has not been previously reported. The LWRs show an allometric positive growth. The relative condition factor shows that 46% of the specimens had poor growth, while the rest were in good condition. Minnow traps were an efficient tool for small fish capture