Researchers tackle inequalities related to cervical cancer screening

University of Tartu researchers participate in a European-wide cooperation project aiming to reduce inequalities related to cervical cancer screening. The goal is to increase the screening ratios among vulnerable women from 26% to 45% which could save the lives of 6,000 to 7,000 women each year.

In Europe, over 61,000 women are diagnosed with cervical cancer each year and almost 26,000 of them will die of it. Each such death is a tragedy, considering that cervical cancer is today a preventable and treatable disease.

Professor of Epidemiology of the University of Tartu Anneli Uusküla, who represents Estonia in the international project CBIG-SCREEN, said the relatively high death rate has been largely attributed to low vaccination coverage and low cervical cancer screening rates among vulnerable women. “Though screening programmes have been shown to drastically reduce cervical cancer mortality, they remain largely inaccessible by subpopulations of vulnerable women. Few of these women take part in screening programmes. This creates inequality in the Estonian healthcare system as well as across Europe and adds to the challenges underserved populations already face in their efforts to maintain their wellbeing,” Uusküla said.

Involving incarcerated women and women with HIV

The vulnerable subpopulations CBIG-SCREEN will focus on are women of low socioeconomic status, women living with HIV, incarcerated women, sex workers and migrants who may not have had access to cancer screening in their country of origin but find it difficult to navigate health care systems in their new homes.

Professor Uusküla said that in Estonia, the situation with cervical cancer morbidity is particularly bad, especially in comparison with our Nordic neighbours and other countries in western Europe. “Overview of the situation of vulnerable women is largely inadequate. In her forthcoming paper, Junior Research Fellow of Public Health Anna Tisler describes that even compared to the generally poor screening coverage of general female population in Estonia, the coverage of women living with HIV is significantly worse,” said Uusküla.

The study identifies relevant improvement actions and discusses them with the women in the target group. The consortium will develop strategies to meet their needs to attract them to the screening programmes and to retain them from initial test to treatment. Through continuous dialogue, it aims to convince policymakers to adopt these strategies ensuring that national screening programmes reach out to the communities of underserved women.

The project will thus create a Europe-wide knowledge framework around barriers to cervical cancer screening and generate policies, programmes, communications and other required services to overcome these barriers.

Participation of the University of Tartu

The University of Tartu is participating in the project from its start to finish, from literature review to testing the results of the study. Among other activities, University of Tartu researchers will be leading one of three intervention studies to assess the efficiency of screening to be developed. The study will be carried out in Estonia.