Article Text
Abstract
Introduction/Background*Sistematic cervical cancer screening covering 70% of population has shown a decrease in the incidence and mortality in northen Europe of over 80%.
In the Basque Country, we implemented cervical screening in 1985. Inicially, unorganized opportunistic screening took place, moving on to an organized opportunistic screening. Since 2018 organized population screening has been carried out which will be completed in 2023.
Methodology Cervical cancer cases detected between 2018 and 2020 have been analysed, both inside and outside the screening. We centered our analysis on the stages of cancer at diagnosis and ulterior prognosis
Result(s)*The total of cancers diagnosed was 294: 92 in 2018, 92 in 2019 and 110 in 2020.
The mean age at diagnosis was 54 years.
Regarding histology, we found squamous carcinoma in 71.2% of the cases, adenocarcinoma in 27.2%, endometrioid in 1.1% and clear cervical cell carcinoma in 0.5%.
Within our programme, 25.5% of the subjets were directly diagnosed after the performance of a VPH cytology and 10.33% during the follow up,
Outside screening, 51,63% were diagnosed after symptoms, 2,72% due to findings in imaging test and 9.78% of cases were detected in private clinics.
68.18% of cancers diagnosed by the programme were initial stages. However, only 13.95% of those diagnosed outside the screening were in an initial stage.
Taking into consideration all the cases, 37.5% of cases did not do any screening test before, 27.2% did, 26.1% did a correct it incorrectly and 9.2% did the follow-up in private clinics.
Finally, concerning mortality up to January 2021, 4.16% of women diagnosed in initial stages and 22.03% diagnosed in advance stages died (10.34% and 89.66% of total deaths, respectively).
Conclusion*FIGO staging is the main prognostic factor, 89.66% of deaths were diagnosed in an advanced stage. According to our study, 68.18% of the cancers diagnosed inside the screening were in initial stages, comparing to only a 13.95% outside the programme.
64.7% of women with cervical cancer had not previously performed a screening test or have it in an inappropriate way. The establishment of a sistematic cervical cancer screening programme can reduce global mortality due to this disease.