2021-11-16-世界卫生组织-Cervical_cancer_Gabon_2021_country_profile_1页_64kb

Cervical Cancer Summary

Core Statistics

• Crude cervical cancer incidence per 100,000 women (2020): 21.6
• Age-standardized cervical cancer incidence per 100,000 women (2020): 30.8
• Cumulative risk of cervical cancer (ages 0-74, 2020): 3.4%
• Cervical cancer deaths (2019): 96
• Cervical cancer mortality-to-incidence ratio (2020): 0.5
• Population-based cancer registry (2021): No

Primary Prevention

• HPV vaccination programme coverage among girls (2020): Not included in the national vaccination schedule
• HPV included in national vaccination programme (2020): No
• Scale, year of introduction, and primary target cohort of HPV vaccination programme (2020): Data not available

Related Risk Factors

• Tobacco use prevalence among women aged 15+ years (2020): Not determined (ND)
• Condom use at last high-risk sex (2012): 64%
• HIV incidence per 1000 women aged 15+ years (2020): 0.92

Secondary Prevention

• National screening programme for cervical cancer (2021): Yes
• Primary screening test used (2021): Cytology
• Target age range of screening programme (2021): 25+ years
• Programme/guidelines to strengthen early detection at primary health care level (2021): Yes
• Clearly defined referral system from primary to secondary/tertiary care (2021): Yes
• Screening coverage (2019): Fewer than 1 in 10 women have been screened in the last 5 years

Treatment and Supportive Care

• National guidelines on cervical cancer management (2021): No
• Radiotherapy units per 10,000 cancer patients (2018): 11
• Brachytherapy units per 10,000 cancer patients (2018): 0
• Cancer diagnosis and treatment services generally available (2021):
  • Cancer centre or department at tertiary level: Yes
  • Pathology services (laboratories): Yes
  • Cancer surgery: Yes
  • Chemotherapy: Yes
  • Radiotherapy: Yes

Medical Staff Availability (per 10,000 cancer patients)

• Radiation oncologists (2019): Not determined (ND)
• Medical physicists (2019): Not determined (ND)
• Surgeons: Not determined (ND)
• Radiologists (2019): Not determined (ND)
• Nuclear medicine physicians (2019): 6

Palliative Care for NCDs

• Palliative care in primary health care facilities (2021): No
• Palliative care in community or home-based care (2021): No
• Oral morphine availability per capita (2017): 0mg

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 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

Key Observations

• Cervical cancer incidence and mortality rates are notable, with a mortality-to-incidence ratio of 0.5, indicating a significant proportion of cases result in death.
• There is no national HPV vaccination programme, which is a critical component of primary prevention.
• A national screening programme exists, but coverage remains low, with fewer than 10% of women screened in the last 5 years.
• While cancer diagnosis and treatment services are generally available, there is a lack of national guidelines for cervical cancer management.
• The availability of medical staff, particularly radiation oncologists and medical physicists, is not determined, suggesting potential gaps in specialized care.
• Palliative care services for patients with non-communicable diseases (NCDs) are not generally available in primary or community settings.
• The absence of a population-based cancer registry and limited HPV vaccination coverage pose challenges to achieving the WHO 2030 elimination targets.