Page 76 - S. Ličen, I. Karnjuš, & M. Prosen (Eds.). (2019). Women, migrations and health: Ensuring transcultural healthcare. Koper, University of Primorska Press.
P. 76
rej Cör
timated 570,000 new cases in 2018 representing 6.6 of all female can-
cers (see http://www.who.int/immunization/diseases/hpv/en/). Wide differ-
ences in cervical cancer incidence and mortality have been observed around
the word. Rates of cervical cancer are inversely proportional to screening
and treatment access, and poor and minority women face more barriers to
healthcare access (Jeudin et al., 2014).
Almost all cervical cancer deaths could be avoided if known effective in-
terventions were available to all women and implemented, including immu-
nizing adolescent girls against HPV and cervical screening and treatment
of pre-cancerous lesions. In Slovenia, we observe significant decreases in
incidence and mortality of cervical cancer in recent decades, and this has
been attributed to appropriate screening program named ZORA. Screen-
ing aims to detect precancerous changes, which, if not treated, may lead
to cancer. The crude incidence rate of invasive cervical cancer in Slovenia
increased from 22.5/100,000 in 1950 to 33.4/100,000 in 1962 and then de-
creased to 20.7/100,000 in 2003 and much more to 7.9/100,000 in 2017 (see
https://zora.onko-i.si/program-zora). In Slovenia screening program ZORA
for early detection of cervical cancer was established in 2003 and covers
most of the resident population. Screening rates remain low for certain sub-
groups of women, including immigrants and refugee women and delayed
sexual health screening may result in late diagnosis and treatment of cervical
cancer (Mcmullin, Alba, Chávez, & Hubbell, 2005).
Increased effort to screen for cervical cancer predominantly via Papanico-
lau (Pap) tests has tremendously reduced cervical cancer morbidity and mor-
tality in many developed countries; however, in many low- and medium- in-
come countries efficient screening programs have not been established. Un-
fortunately those countries have also high prevalence of HPV infection.
Cervical cancer continues to be important health problem in Slovenia for
immigrant and refugee women. Several studies have shown that migrant
women from low- and medium- income countries have higher risk of cervi-
cal cancer than native women. This population has a comparatively high inci-
dence of pre-invasive cervical lesions, cervical cancer, and mortality from the
disease (McComb, Ramsden, Olatunbosun, & Williams-Roberts, 2018). During
the years 2000–2004 the cervical cancer in women from Central and East-
ern Europe and living in Italy was 38.3 per 100,000, which is statistically sig-
nificant higher than that of the native Italian women (6 per 100.00) (Torne-
sello, Giorgi Rossi, Buonaguro, Buonaguro, & HPV Prevalence Italian Work-
ing Group, 2014). These disparities may be explained by lower participation
in screening programs as well as higher rates of fertility and HPV infection.
74
timated 570,000 new cases in 2018 representing 6.6 of all female can-
cers (see http://www.who.int/immunization/diseases/hpv/en/). Wide differ-
ences in cervical cancer incidence and mortality have been observed around
the word. Rates of cervical cancer are inversely proportional to screening
and treatment access, and poor and minority women face more barriers to
healthcare access (Jeudin et al., 2014).
Almost all cervical cancer deaths could be avoided if known effective in-
terventions were available to all women and implemented, including immu-
nizing adolescent girls against HPV and cervical screening and treatment
of pre-cancerous lesions. In Slovenia, we observe significant decreases in
incidence and mortality of cervical cancer in recent decades, and this has
been attributed to appropriate screening program named ZORA. Screen-
ing aims to detect precancerous changes, which, if not treated, may lead
to cancer. The crude incidence rate of invasive cervical cancer in Slovenia
increased from 22.5/100,000 in 1950 to 33.4/100,000 in 1962 and then de-
creased to 20.7/100,000 in 2003 and much more to 7.9/100,000 in 2017 (see
https://zora.onko-i.si/program-zora). In Slovenia screening program ZORA
for early detection of cervical cancer was established in 2003 and covers
most of the resident population. Screening rates remain low for certain sub-
groups of women, including immigrants and refugee women and delayed
sexual health screening may result in late diagnosis and treatment of cervical
cancer (Mcmullin, Alba, Chávez, & Hubbell, 2005).
Increased effort to screen for cervical cancer predominantly via Papanico-
lau (Pap) tests has tremendously reduced cervical cancer morbidity and mor-
tality in many developed countries; however, in many low- and medium- in-
come countries efficient screening programs have not been established. Un-
fortunately those countries have also high prevalence of HPV infection.
Cervical cancer continues to be important health problem in Slovenia for
immigrant and refugee women. Several studies have shown that migrant
women from low- and medium- income countries have higher risk of cervi-
cal cancer than native women. This population has a comparatively high inci-
dence of pre-invasive cervical lesions, cervical cancer, and mortality from the
disease (McComb, Ramsden, Olatunbosun, & Williams-Roberts, 2018). During
the years 2000–2004 the cervical cancer in women from Central and East-
ern Europe and living in Italy was 38.3 per 100,000, which is statistically sig-
nificant higher than that of the native Italian women (6 per 100.00) (Torne-
sello, Giorgi Rossi, Buonaguro, Buonaguro, & HPV Prevalence Italian Work-
ing Group, 2014). These disparities may be explained by lower participation
in screening programs as well as higher rates of fertility and HPV infection.
74
