Cervical cancer screening attendance related factors among women in Latvia

Cervical cancer is the second leading cause of death in Latvia among women aged 15-44. Since 2009 organized cancer screening has been available, but responsiveness from the target population was still not optimal - only half of the invited persons participated in screening in 2022. Our study aimed to analyse sociodemographic factors and knowledge about screening concerning participation in the screening procedure. Data from a cross-sectional population survey conducted in 2021-2022 were analysed (n = 1313). The survey was part of the project “Towards elimination of cervical cancer: intelligent and personalized solutions for cancer screening” (EMP416). A multivariate model was adjusted for independent variables found to be statistically significantly associated with the outcome in univariate analysis. The dependent variable was participation in cervical cancer screening. Independent variables - knowledge about screening, age, education, marital status, and employment 81 % (n = 1063) of respondents participated in cervical cancer screening. The odds of screening attendance were higher among women aged 30-39 (aOR=3.6, p < 0.001), 40-49 (aOR=2.8, p = 0.005), 50-59 (aOR=12.3, p = 0.001) in comparison to women aged 25-29 years. Secondary (aOR=5.9, p < 0.001) and university (OR = 13.1, p < 0.001) education in comparison to primary education and being married (OR = 3.7, p < 0.001) to being single, as well as being employed (OR = 2.0, p = 0.085) and economically inactive (OR = 3.1, p < 0.05) in comparison to unemployment was associated with cervical cancer screening attendance. Knowledge about screening was associated with higher odds of participation (OR = 4.1, p = 0.001). Knowledge about screening is positively related to attendance. Differences were observed across various sociodemographic groups emphasizing the importance of providing targeted information for vulnerable social groups such as the elderly, single and unemployed women, and women with lower education to promote cervical cancer screening.Peer reviewe

Comment on "The European response to the WHO call to eliminate cervical cancer as a public health problem"

Funding Information: This work was supported through grant EMP416 from the EEA (European Economic Area) and Norway Grants.publishersversionPeer reviewe

Aerobic vaginitis - underestimated risk factor for cervical intraepithelial neoplasia

Funding Information: Funding: Grant for this project (RSU ZP 04/2013, code 035, Investigation of clinical and molecular features of cervical cancer to improve early diagnosis and treatment strategy) was provided by Riga Stradins university. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.The aim of this study is to analyse the association between vaginal microbiota and the histological finding of CIN. From July 2016 until June 2017, we included 110 consecutive patients with abnormal cervical cytology results referred for colposcopy to Riga East Clinical University Hospital Outpatient department in the study group. 118 women without cervical pathology were chosen as controls. Certified colposcopists performed interviews, gynaecological examinations and colposcopies for all participants. Material from the upper vaginal fornix was taken for pH measurement and wet-mount microscopy. Cervical biopsy samples were taken from all subjects in the study group and in case of a visual suspicion for CIN in the control group. Cervical pathology was more often associated with smoking (34.6% vs. 11.0%, p <0.0001), low education level (47.2% vs. 25.5%, p = 0.001), increased vaginal pH (48.2% vs. 25.4%, p < 0.0001), abnormal vaginal microbiota (50% vs. 31.4%, p = 0.004) and moderate to severe aerobic vaginitis (msAV) (13.6% vs. 5.9%, p = 0.049) compared to controls. The most important independent risk factors associated with CIN2+ were smoking (OR 3.04 (95% CI 1.37–6.76), p = 0.006) and msAV (OR 3.18 (95% CI 1.13–8.93), p = 0.028). Bacterial vaginosis (BV) was found more often in CIN1 patients (8/31, 25.8%, p = 0.009) compared with healthy controls (8/118, 6.8%), or CIN2+ cases (8/79, 10.1%). In the current study msAV and smoking were the most significant factors in the development of CIN in HPV-infected women, especially high grade CIN. We suggest that AV changes are probably more important than the presence of BV in the pathogenesis of CIN and progression to cervix cancer and should not be ignored during the evaluation of the vaginal microbiota.publishersversionPeer reviewe

Cervical Cancer in the Baltic States : Can Intelligent and Personalized Cancer Screening Change the Situation?

Copyright © 2022 Mindaugas Stankūnas, Kersti Pärna, Anna Tisler, Anda Ķīvīte-Urtāne, Una Kojalo, Jana Zodzika, Nicholas Baltzer, Jan Nygard, Mari Nygard, Anneli Uuskula. Published by Vilnius University Press.The three Baltic States (Estonia, Latvia, and Lithuania) are among the European Union countries with the highest incidence and mortality rates for cervical cancer. In order to tackle this public health challenge, there is an urgent need to implement more advanced and effective methods in cervical cancer prevention in Baltic countries. Nationwide cervical cancer screening programs in the Baltic States commenced in 2004-2009. While the organized screening programs in these countries differ in some relevant details (target age groups, screening interval), the underlying principles and problems, barriers are universal. However, the outcomes of present screening programs are unsatisfactory. In addition, universal screening programs are extremely costly. There is a potential need for more intelligent and personalized cervical cancer screening program. In 2019 the project "Towards elimination of cervical cancer: intelligent and personalized solutions for cancer screening" (2020-2023) was developed with the main objective - to develop improved and personalized cancer screening methods within a sustainable health care system. It is expected, that more sophisticated cervical cancer screening model will be implemented in Estonia, Latvia, and Lithuania, and will have a positive impact to epidemiology of cervical cancer and public health in general.publishersversionPeer reviewe

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) Consensus Statement on the Management of Vaginal Intraepithelial Neoplasia

Copyright © 2023 ESGO, ISSVD, EFC, ECSVD. Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.Peer reviewedPublisher PD

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) consensus statement on the management of vaginal intraepithelial neoplasia

© ESGO, ISSVD, EFC, ECSVD 2023. Re-use permitted under CC BY. Published by BMJ.Peer reviewedPublisher PD

An overview of cervical cancer epidemiology and prevention in the Baltic States

Abstract Aims To inform future Baltic States-specific policy analyses, we aimed to provide an overview of cervical cancer epidemiology and existing prevention efforts in Estonia, Latvia and Lithuania. Methods A structured desk review: we compiled and summarized data on current prevention strategies, population demography and epidemiology (high risk human papillomavirus (HPV) prevalence and cervical cancer incidence and mortality over time) for each Baltic State by reviewing published literature and official guidelines, performing registry-based analyses using secondary data and having discussions with experts in each country. Results We observed important similarities in the three Baltic States: high burden of the disease (high incidence and mortality of cervical cancer, changes in TNM (Classification of Malignant Tumors) stage distribution towards later stage at diagnosis), high burden of high-risk HPV in general population and suboptimal implementation of the preventive strategies as low screening and HPV vaccination coverage. Conclusions Cervical cancer remains a substantial health problem in the region and the efforts in addressing barriers by implementing a four-step plan for elimination cervical cancer in Europe should be made. This goal is achievable through evidence-based steps in four key areas: vaccination, screening, treatment, and public awareness