2021-11-16-世界卫生组织-Cervical_cancer_Guyana_2021_country_profile_1页_65kb

Cervical Cancer Summary

Core Content

The document provides an overview of cervical cancer incidence, mortality, prevention, and treatment status in a specific region, along with alignment to the WHO Cervical Cancer Elimination Strategy Targets for 2030.

Incidence and Mortality

• Crude cervical cancer incidence per 100 000 women (2020): 31
• Age-standardized cervical cancer incidence per 100 000 women (2020): 29.5
• Cumulative risk of cervical cancer, ages 0-74 (2020): 3.2%
• Cervical cancer deaths (2019): 91
• Cervical cancer mortality-to-incidence ratio (2020): 0.52
• Population-based cancer registry exists (2021): Yes

These statistics highlight the prevalence and impact of cervical cancer in the population, with a notable mortality rate relative to incidence. The presence of a population-based cancer registry indicates a structured system for tracking and monitoring cervical cancer cases.

Primary Prevention

• HPV vaccination programme coverage among girls (2020): 1 in 10 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: 2017
• Primary target cohort: 9-16 years

The HPV vaccination programme is in place and targets a national cohort, but its coverage remains relatively low. This suggests a need for increased awareness and accessibility to improve vaccination rates.

Risk Factors

• Tobacco use prevalence, women aged 15+ years (2020): 2%
• Condom use at last high-risk sex (2009): 63%
• HIV incidence per 1000, women aged 15+ years (2020): 0.55

Tobacco use is low, condom use was reported at 63% in 2009, and HIV incidence is relatively low. These factors may contribute to lower cervical cancer risk, but ongoing monitoring and intervention are still necessary.

Secondary Prevention

• National screening programme for cervical cancer exists (2021): Yes
• Primary screening test used: VIA (Visual inspection with acetic acid)
• Target age range of programme: 25-49 years
• Programme/guidelines to strengthen early detection at primary health care level (2021): No
• Clearly defined referral system from primary to secondary/tertiary care (2021): Yes
• Screening coverage (2019): 1 in 10 women have been screened for cervical cancer in the last 5 years

A national cervical cancer screening programme exists, utilizing VIA as the primary test, targeting women aged 25-49. However, there are no guidelines for early symptom detection at the primary health care level, which may limit early intervention opportunities. The referral system is well-defined, but screening coverage remains low.

Treatment and Supportive Care

• National guidelines on cervical cancer management exist (2021): No
• Radiotherapy units per 10 000 cancer patients (2021): 9
• Brachytherapy units per 10 000 cancer patients (2021): 9
• Cancer diagnosis and treatment services generally available (2021):
  • Cancer centre or department at tertiary level: Yes
  • Pathology services: No
  • Cancer surgery: Yes
  • Chemotherapy: No
  • Radiotherapy: No

Despite the availability of cancer centres and surgery, key diagnostic and treatment services such as pathology and chemotherapy are not available. Radiotherapy and brachytherapy units are present, but their coverage is limited. The absence of national guidelines for cervical cancer management indicates a gap in standardized care protocols.

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

These targets emphasize the importance of primary and secondary prevention in reducing cervical cancer burden. The current coverage of HPV vaccination and cervical screening falls significantly short of these goals, indicating a need for improved public health initiatives and healthcare infrastructure.