New challenges for cervical cancer

One of the most common types of cancer found in women throughout the world is cancer of the cervix. Nationwide screening programmes, as commonly used in the developed world, have demonstrated significantly reduced rates of cervical cancer, thus in such cases leading to decreased mortality rates. In developing countries, indicators of cervical cancer are increasing. In Poland, as in other countries, we can observe a significant disproportion of its occurrence among different populations of women. During the first half of the 1990s, cervical cancer was the second most prevalent cancer in Poland. Since then its morbidity and mortality rates have gradually decreased. This trend has continued on from the second half of the 1980s, when the standardised morbidity rate decreased to 17.2/100,000 women. In 2010 this further decreased to 10.3/100,000 women. In the early seventies, the standardised mortality rate for cervical cancer in Poland was 9.2/100,000 women. At the moment, the cervical cancer mortality rate in Poland is 5.2/100,000 women. Nevertheless, we still observe higher rates of morbidity and mortality from cervical cancer compared to other developed countries. Following European Commission recommendations, Poland launched a nationwide programme for cytological screening in 2007. In 2009, 26.77% of women took part in the cervical screening programme. Data from subsequent years have not been published, but even if an upward trend is maintained within the first years of the programme, it seems that only around 1/3 of Polish women are covered. The low screening level is a major drawback in the attempt to reduce cervical cancer rates in Poland. We also do not have precise data on how many actual Pap tests are performed or on those women who have never had such tests done. It therefore seems necessary that such data be obtained to enable a high risk group of death from cervical cancer to be defined and appropriate countermeasures to be undertaken. Key wOrds: cervical cancer, cervical cytology, human papillomavirus (HPV), human papillomavirus vaccination, cancer prevention. address fOr cOrrespOndence: Cezary Wojtyła, First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education in Warsaw, 231 Czerniakowska St., 00-416 Warsaw, Poland, e-mail: czwo@op.pl DOI: 10.5114/jhi.2016. 61425 INtrODUctION One of the most common types of cancer found in women throughout the world is cancer of the cervix. The vast majority of such cases are diagnosed in developing countries where there are no efficient programmes for the early detection of precancerous changes [1]. However, countrywide screening programmes, as commonly used in the developed world, have demonstrated significantly reduced rates of cervical cancer, thus in such cases leading to decreased mortality rates. In developing countries, indicators of cervical cancer are increasing [2]. When epidemiological data from prosperous countries are studied, significant disparities have been found. Women living in rural areas or those from low-income families tend to have the highest cervical cancer morbidity and mortality rates [2]. Defining those groups of women vulnerable to developing cervical cancer is currently a vital area for the prevention of this disease, which can now in fact be easily averted and early states indeed treated.