OBJECTIVE
To elaborate an algorithm for organized visual cervical cancer (CC) screening acceptable for the functioning healthcare system in the Republic of Tajikistan.
SUBJECTS AND METHODS
The investigation concept is based on an integrated approach to exploring the epidemiological and clinical aspects of CC in the regions of Tajikistan and the republic as a whole over 2010—2020. The investigation was performed by the Republican Cancer Research Center, Ministry of Health and Social Protection of the Population of the Republic of Tajikistan. The authors comparatively analyzed the results of a 5-year (2016—2020) study focusing on the adaptation of the health care system in the Republic of Tajikistan and on the national implementation of the WHO-recommended SS screening and treatment tactics done in two pilot districts: Kushonien, Khatlon Region, and B. Gafurov, Sughd Region. Inspection of the cervix after aqueous iodine solution treatment was used as a method of visual screening. The target group included women aged 30—49 years. The CC screening participants were 41.700 (the target group coverage was 95.1%) residents in the B. Gafurov District and 26.691 (the coverage was 93%) in the Kushonien District.
RESULTS
A three-stage visual CC screening algorithm was elaborated and tested in the pilot study. The overall coverage of the target groups in the pilot districts was 94.2% (68.391 women out of the 72.574 included in the target group). Histological examination revealed cervical intraepithelial neoplasia (CIN) I in 0.14% (n=99), CIN II in 0.03% (n=24), and CIN III in 0.06% (n=41). The invasive CC detection rate was 0.02%; the early stage of CIN I + II was detected in 6 out of the 16 diagnosed cases.
CONCLUSION
The results of the pilot study formed the basis for the introduction of the visual CC screening program at the national level. Taking into account the characteristics of the healthcare system in the Republic of Tajikistan, the use of this screening model makes it possible to increase the availability of women’s participation in CC screening and target group coverage.
