2021-11-16-世界卫生组织-Cervical_cancer_Ecuador_2021_country_profile_1页_65kb

Cervical Cancer Summary

Core Content

The document provides an overview of the current status of cervical cancer in terms of incidence, mortality, prevention, and treatment. It also outlines the WHO Cervical Cancer Elimination Strategy Targets for 2030.

Incidence and Mortality

• Crude cervical cancer incidence per 100,000 women (2020): 17.4
• Age-standardized cervical cancer incidence per 100,000 women (2020): 16
• Cumulative risk of cervical cancer, ages 0-74 (2020): 1.7%
• Cervical cancer deaths (2019): 840
• Cervical cancer mortality-to-incidence ratio (2020): 0.53
• Population-based cancer registry exists (2021): Yes

These statistics indicate that cervical cancer remains a significant public health issue, with a notable incidence rate and a mortality-to-incidence ratio that suggests a substantial proportion of cases result in death. The presence of a population-based cancer registry in 2021 highlights the country's commitment to monitoring and addressing the disease.

Primary Prevention

• HPV vaccination programme coverage among girls (2020): 70% of girls turning 15 years old received their final HPV vaccination dose
• HPV included in national vaccination programme: Yes
• Scale of vaccination programme: National
• Year of introduction: 2014
• Primary target cohort: 9 years

The country has implemented a national HPV vaccination programme targeting 9-year-olds, with 70% of girls receiving the final dose by 2020. This is a key primary prevention strategy against cervical cancer.

Secondary Prevention

• National screening programme for cervical cancer exists (2021): Yes
• Primary screening test used (2021): Cytology (HPV test from 30 years)
• Target age range of programme (2021): 21-65 years
• Programme/guidelines exist to strengthen early detection at primary health care level (2021): Yes
• Clearly defined referral system exists from primary care to secondary and tertiary care (2021): Yes
• Screening for cervical cancer (2019): 5 in 10 women have been screened in the last 5 years

A national cervical cancer screening programme is in place, targeting women aged 21-65. Cytology is the primary screening method, with HPV testing introduced for women aged 30 and above. Early detection and referral systems are well-defined, and screening coverage is moderate, with 50% of women having been screened in the last five years.

Treatment and Supportive Care

• National guidelines on cervical cancer management exist (2021): No
• Number of radiotherapy units per 10,000 cancer patients (2021): 9
• Number of brachytherapy units per 10,000 cancer patients (2021): 2
• Cancer diagnosis and treatment services generally available (2021): Yes (including cancer centres, pathology services, cancer surgery, chemotherapy, and radiotherapy)
• Medical staff per 10,000 cancer patients (2019):
  • Radiation oncologists: ND
  • Medical physicists: 3
  • Surgeons: 1946
  • Radiologists: 154
  • Nuclear medicine physicians: 4

The country has access to essential cancer diagnosis and treatment services, including radiotherapy and brachytherapy. However, national guidelines for cervical cancer management are not currently available. There is a sufficient number of medical staff, particularly surgeons, to support cancer care.

WHO Cervical Cancer Elimination Strategy Targets for 2030

• 90% of girls fully vaccinated with the HPV vaccine by the age of 15
• 70% of women are screened with a high-performance test by 35 years of age and again by 45 years of age
• 90% of women identified with cervical disease receive treatment

The WHO strategy outlines ambitious targets for cervical cancer elimination, focusing on increasing vaccination rates, improving screening coverage, and ensuring timely treatment for affected women. Current efforts are in line with some of these targets, but further progress is needed to meet the 2030 goals.