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A.G. ZHUMAGALIYEVA, M. KALIYEVA
ANALYSIS OF THE RESULTS OF SCREENING OF CERVICAL CANCER
Resume: This article summarizes the results of screening for cervical cancer in 2016 in the city polyclinic №4 of Aktobe by conducting a retrospective analysis.
The findings suggest, firstly, of the breadth of coverage of cervical cancer screening, which indicates the high level of women's joint responsibility for their own health and the efficient conduct of the medical staff of a city polyclinic №4 health education. Secondly, the high detection rate of precancerous changes is proof of the effectiveness of screening tests in the diagnosis of cervical cancer. Precancerous changes, in particular, erosion and ectropion of cervix uteri, are more common in the age of 30, indicating that the trend of rejuvenation of the disease.
Thus, the above results are a confirmation of the diagnostic value of cervical cancer screening in order to identify asymptomatic preclinical forms of cancer and its early stages. Keywords: cervical cancer screening, cervical cancer
А.Г. ЖУМАГАЛИЕВА, М.С. КАЛИЕВА
АНАЛИЗ ИТОГОВ СКРИНИНГА НА ВЫЯВЛЕНИЕ РАКА ШЕЙКИ МАТКИ
Резюме: Важность проблемы рака шейки матки (РШМ) для общественного здравоохранения определяется его серьезным бременем на общество не только в связи с человеческими страданиями, но также финансовыми последствиями для системы здравоохранения.
проанализировать результаты скрининговых исследований на выявление рака шейки матки, тем самым определить роль скрининга в раннем выявлении РШМ.
Проведен ретроспективный анализ статистических данных по результатам проведения скрининга женщин в возрасте 30, 35, 40, 45, 50, 55 и 60 лет на выявление рака и предопухолевых заболеваний шейки матки в Городской поликлинике №4 г. Актобе за 2016 год.
Полученные данные свидетельствуют, во-первых, о широте охвата скрининга РШМ, что указывает на высокий уровень солидарной ответственности женщин за свое здоровье и эффективное проведение санитарно-просветительной работы медицинскими сотрудниками городской поликлиники №4. Во-вторых, отсутствие рака шейки матки и высокая выявляемость предраковых заболеваний является доказательством эффективности скрининговых исследований в диагностике рака шейки матки. Предраковые изменения, в частности эрозия и эктропион шейки матки, встречаются чаще в возрасте 30 лет, что говорит о тенденции омоложения данной патологии.
Таким образом, изложенные результаты являются подтверждением диагностической ценности скрининга рака шейки матки с целью выявления доклинических бессимптомных форм рака и ранних его стадий. Ключевые слова: рак шейки матки,скрининг, скрининг рака шейки матки.
УДК 616.146-006-036.22
D.R. KAIDAROVA, M.R.KAIRBAYEV, R.O. BOLATBEKOVA
Department of Internship and Residency in Oncology. Asfendiyarov Kazakh National Medical University
MORBIDITY AND MORTALITY FROM CERVICAL CANCER FROM 2010 TO 2014 AFTER INTRODUCTION NATIONAL SCREENING PROGRAMM
Cervical cancer in Kazakhstan among the female population occupies II place after breast cancer, which is carry 2 women's lives in the most active age daily. Analysis of intensive incidence rates of cervical cancer was showed an increase in the detection rate of this disease in the period from 2010 to 2014. The sharp increase in morbidity is associated with increased incidence of cervical cancer due to the introduction of screening programs.The analysis of age morbidity revealed a significant risk of the disease at a young age and noticeable increase it to 40-44 years.ln the analysis of cervical cancer in the context of the stages is showed increasing in the detection rate of this disease in the first stage for the period from 2010 to 2014. Keywords: cervical cancer, incidence, mortality, screening, the Republic of Kazakhstan.
Background.
Cervical cancer in Kazakhstan among the female population occupies II place after breastcancer, which is carry 2 women's lives in the most active age daily[1,2]. Routine inspections in the women's offices have been started in our country since 2005. Order № 607 "On improvement of preventive inspections of certain categories of adult population" was issued by the Ministry
of Health of Republic of Kazakhstan in 2008, thenin 2009, order №685 «On approval of Rules of carrying out of preventive medical examinations of the target population" was issued. There is a national screening program for cervical cancer using PAP smear with the assessment on the classification of Bethesdas ince 2008 [3]. Screening carried out for women from 30 to 60 years of age with an interval of 5 years. Implementation of this
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program began in step-by-step, starting with training specialists, the organization of women's offices [4]. Objective.To evaluate the incidence of cervical cancer rates as well as mortality from him for 2010-2014 in the Republic of Kazakhstan after the introduction of screening.
Materials and methods. Used basic medical reporting and recording forms and cancer registry database of malignant neoplasms and cervical cancer, as well as information about the number of the female population and composition by age. Extensive, intensive and
standardized indicators, both general and age-specific calculated by the standard method of health statistics. Results. Analysis of intensive incidence rates of cervical cancer was showed an increase in the detection rate of this disease in the period from 2010 to 2014 (Figure 1). In 2010 the incidence rate was 16.2 per 100 000 female population, and in 2014 was 20.2 per 100 000 female population. A similar trend was confirmed by standardized indicators. The sharp increase in morbidity is associated with increased incidence of cervical cancer due to the introduction of screening programs.
25
20
15
10
y = 0,96x + 15,22 R2 = 0,9234
y = 0,88x + 14,8 _R2 = 0,9339
2010
2011 Intensive rates
2012 2013
World standardized rates
2014
5
0
Figure 1 - Dynamics of intensive and World standardized incidence rates of cervical cancer per 100 000 female population of
the Republic of Kazakhstan for the period 2010-2014
The analysis of age morbidity (Figure 2) revealed a confirms the necessity of improving and strengthening
significant risk of the disease at a young age and the screening of young and middle-aged women.
noticeable increase it to 40-44 years. The age distribution
Figure 2 - Age-related incidence rates of cervical cancer of women of the Republic of Kazakhstan (average per 100 000 female population of the appropriate age for 2010-2014)
There are some differences in the frequency of primary incidence in the southern regions of Kazakhstan: South
cervical cancer depending on the territory (Figure 3). An Kazakhstan, Zhambyl and Kyzylorda regions (statistically
analysis of the five-year period showed a higher incidence significant differences of the average values). rates in Almaty, Kostanai and Atyrau regions, and lowest
25
20
15
10
П5 П5 П5 3 с
T3 T3 П5 П5
с П5 aa П5 +J (Л о +J (Л 'сю -П +J +J (Л -П
П5 О M С о со м П5
П5 £ П5 00
2010-2014гг
Figure 3 - Territorial incidence rates of cervical cancer in the Republic of Kazakhstan (standardized average World indicators per 100 000 female population) for 2010-2014
In the analysis of cervical cancer in the context of the stages is showed increasing in the detection rate of this disease in the first stage for the period from 2010 to 2014 (Figure4). 1075 women with malignant cervical neoplasms were detected in the first stage in 2009, and 1,467 was detected in 2014 which describes a statistically
significant increasing. This trend is associated with the successful implementation of the national screening program for early detection of cervical cancer. You can also notice a decreasing in the detection of cervical cancer in the third stage, but detection in advanced stage remains the same.
120 100 80 60 40 20 0
85,5
80 80 81 81
17,7 17,15 15,5 П С 12,3
2,3 3,3 2010 2011 ■ I-II стадии -V-' 3 2012 2013 ■ III стадия ■ IV стадия 2014
Figure 4 - The proportion of I-II, III and IV stages of newly diagnosed cases of malignant cervical tumors in the
Republic of Kazakhstan (%)
According to the Cancer Registry in 2014 82% of women were found in the early stages, where 23% were detected by prophylactic examinations. There is a marked increase in the detection of cervical cancer in the initial stages in 2014 compared with 6.68% in 2008 due to the effective operation of the screening program. It is noted a slight increase observed patients by dispensaries in 2014, 11 111, where 54.18% are registered more than 5 years.
Analysis of the screening work for the period from 2011 to 2014 showed a noticeable increase detection of malignant cervical tumors in stage I-II from 88.7 to 95.4. It is also a marked decline in detection of cervical cancer at advanced stage to 0.8 in 2014, due to the effective work of the national screening program.
Regions Cytologic screening
I-II stages IV stage
2011 2012 2013 2014 2011 2012 2013 2014
RepublicofKazakhstan 88,7 91,2 95,2 95,4 1,2 1,5 0,5 0,8
5
0
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At the moment, the Kazakh Research Institute of Oncology and Radiology and Department of Medical Assistance of the Ministry of Health and Social Development is actively working to improve the quality of screening, designed, carried out organizational and methodical work, is developing national guidelines for the organization and instruction of screening programs. In the long term expansion of the target groups for cervical cancer
screening and the introduction of vaccination against human papillomavirus high-risk for adolescent girls. Screening for cervical cancer is an integral part of the national screening program, which is one of the leading strategies for the protection of public health in Kazakhstan, included in the software development of public health issues and is financed by the national budget.
REFERENCES
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2 Показатели онкологической службы Республики Казахстан за 2008 год / Арзыкулов Ж.А., Сейтказина Г.Д., Игисинов С.И., Ажмагамбетова А.Е., Махатаева А.Ж., Сейсенбаева Г.Т. , - Алматы: 2008. - 122 с.
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4 Rogovskaya, S. I., Shabalova, I. P., Mikheeva, I. V, Minkina, G. N., Podzolkova, N. M., Shipulina, O. Y., Poljak, M. Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Russian Federation, the Western countries of the former Soviet Union, Caucasus region and Central Asia. // Vaccine. - 2013. - №31 (7). - P. 46-58.
Д.Р. КДЙДАРОВА, М.Р. КДЙРБАЕВ, Р.О. БОЛАТБЕКОВА
Онкология интернатура жэне резидентура кафедрасы С.Д. Асфендияров атындагы Казац ¥лттыцмедицинауниверситетi
СКРИНИНГ ЕН.ПЗУШЕН КЕЙ1НГ1 2010-2014 ЖЖ АРАЛЬ^ЫНДА КАЗАХСТАН РЕСПУБЛИКАСЫНДАFЫ ЖАТЫР МОЙЫНЫ КАТЕРЛ1 1С1Г1НЕН АУЫРУ ЖЭНЕ 0Л1М К0РСЕТК1Ш1
Тушн: Казахстан Республикасында жатыр мойыны к;атерл1 idri ана безшщ к;атерл1 iсiгiнен кешн екiншi орын алады, кунделжт ею эйел eмiрiн алады. 2010-2014 жж аралыгында жатыр мойыны ;атерл1 iсiгiмен ауру керсетк^ багаланды. Ауыру шын,ы керсетк^ сон,гы 4 жыл бойына жас эйелдер катарына ауысуда, ауру керсетюшшщ жогарылауын 40-44 жас аралыгындагы эйелдер курайды. 2004 - 2014 жж аралыгында жатыр мойыны к;атерлi idri стадиялыканализшде бiрiншi стадиянын, аны;талуы жогарылауда.
ТYЙiндi сездер: жатыр мойыны к;атерлi iсiгi, ауыру, eлiм, скрининг, Каза;стан Республикасы.
Д.Р. КАЙДАРОВА, М.Р. КАЙРБАЕВ, Р.О. БОЛАТБЕКОВА
Кафедра интернатуры и резидентуры в онкологии КазНМУ им. С.Д. Асфендиярова
ЗАБОЛЕВАЕМОСТЬ И СМЕРТНОСТЬ ОТ РАКА ШЕЙКИ МАТКИ В ПЕРИОД 2010-2014ГГ ПОСЛЕ ВВЕДЕНИЯ
НАЦИОНАЛЬНОЙ СКРИНИНГОВОЙ ПРОГРАММЫ
Резюме: В Казахстане рак шейки матки среди женского населения занимает II место после рака молочной железы, ежедневно унося 2 женские жизни в самом активном возрасте, а также нанося колоссальный урон всему государству. При анализе грубых интенсивных показателей заболеваемости раком шейки матки отмечается увеличение частоты выявления данного заболевания за период с 2010 по 2014 годы. Резкое увеличение заболеваемости связано с увеличением выявления рака шейки матки в связи с введением скрининговой программы. Проведенный анализ возрастных показателей заболеваемости выявил значительный риск заболевания уже в молодом возрасте и заметное увеличение его к 40-44 годам. При анализе рака шейки матки в разрезе стадий отмечается увеличение частоты выявления данного заболевания в первой стадии за период с 2010 по 2014 годы. Ключевые слова: рак шейки матки, заболеваемость, смертность, скрининг, Республика Казахстан.
