Survey of Participation in Organised Cervical Cancer-Screening Programme in Hungary

Factors Associated With Cervical Cancer Screening Attendance in Hungary Based on the European Health Interview Survey

Objectives

This study assessed the change in cervical cancer screening attendance across 10 years and identified the associated factors.

Methods

Data from the European Health Interview Surveys in Hungary (2009, 2014, 2019) were analyzed with multivariate and multiple logistic regressions.

Results

The analysis involved 4,850 participants, revealing a significant (p < 0.001) increase in screening attendance from 69% to 77% over 10 years. Factors significantly associated with higher attendance rates included a higher education level (tertiary level AOR = 2.51 [2.03-3.09]), being in a relationship (AOR = 1.59 [1.39-1.83]), the belief that one can do much for one's health (OR = 1.26 [1.05-1.52]), and the absence of chronic health problems (AOR = 1.56 [1.33-1.84]). Lower screening odds were significantly correlated with worse self-perceived health status (AOR = 0.65 [0.52-0.81]) and less frequent doctor (AOR = 0.64 [0.54-0.76]) and specialist visits (AOR = 0.46 [0.39-0.53]).

Conclusion

Enhancing cervical cancer screening rates requires tailored public health strategies, particularly targeting individuals with lower education and poor health perceptions. Public health initiatives and enhanced collaboration among healthcare professionals are required to further increase participation rates, particularly among the identified groups.

Working as a cancer survivor in Romania: an overview of the statutory policies for return to work

Purpose: Over the last several years, the number of working-age patients with cancer in Europe and Romania has consistently increased. Considerable efforts are made to bring cancer survivors back to the workforce, generating remarkable individual and societal benefits. Legislation and policies are essential factors in achieving this goal. The aim of the present article is to analyze the Romanian statutory policies for returning to work after cancer.Methods: A comprehensive search using key terms was carried out on the websites of the Ministry of Labor and Ministry of Health and also within the Romanian Official Gazette, which is the official national paper-based repository of legal documents. Nine work-related policy documents were found, and recurrent themes were identified. Within these themes, the authors synthetized the information on provisions, actors, structures, processes and responsibilities.Results: Three themes emerged from the analysis: (1) General and cancer-specific provisions; (2) The cancer survivor's journey in relation to work; and (3) Work adjustments. The policies contain no measures for incentivising return to work. The mechanisms for collaboration and coordination among stakeholders are not described in the policies.Conclusions: The current policies put an emphasis on compensation but fail to encompass activation measures. Considering that, for several components of the return to work process, the general principles are already stated in the law, it is vital to further develop the policies in the sense of specifying the procedures, roles and responsibilities for the stakeholders involved.IMPLICATIONS FOR REHABILITATIONBeing diagnosed with cancer can result in long-term disability and considerable difficulties to reenter the labor market which policy makers need to address.The legislation should focus on providing work-related activities and physical and vocational rehabilitation services to cancer survivors, as measures for an active labor market.The policy should provide vocational rehabilitation and work-related support groups for working-age patients with cancer, starting at the end of the first year of invalidity pension, thus preparing the transition back to the labor market.There is a pressing need to have a country-specific legislation for employers, as they have a tremendous impact on the return to work process.

Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing

Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.

General practitioners can increase participation in cervical cancer screening - a model program in Hungary

BACKGROUND

Cervical cancer is a preventable disease. Unfortunately, its mortality is high in Hungary: 9.2 deaths /100000 women/year in 2015. The Hungarian organized, nationwide cervical screening program was launched in 2003, but it could improve the coverage rate of cervical cancer screening only by a few percentage points. The vast majority of women still uses opportunistic screening and the organized screening program had little impact on participation by women who never or rarely consult their gynecologists. We assessed whether involving general practitioners in the cervical cancer screening process would increase participation.

METHODS

The study consisted of two parts: 1. A questionnaire-based health survey was conducted using a representative sample of women aged 25 to 65 years from 11 Hungarian counties, in which we studied where women obtained information about cervical cancer screening. 2. Additionally, a model program and its evaluation were implemented in the practices of general practitioners in one of the 11 counties (Zala county). In this program, general practitioners were informed of their patients' participation in the cervical cancer screening program, and they motivated those who refused the invitation.

RESULTS

Questionnaire-based health survey: A total of 74% (95% confidence interval (CI): 70-77%) of the target population had a screening examination within the previous 3 years. The majority (58, 95% CI: 54-62%) of the target population did not ask for information about cervical cancer screening at all. Only 21% (95% CI: 17-26%) consulted their general practitioners about cancer screening. Evaluation of the model program: the general practitioners effectively motivated 24 out of 88 women (27, 95% CI: 18-38%) who initially refused to participate in the screening program.

CONCLUSION

The majority of Hungarian women are not informed about cervical cancer screening beyond the invitation letter. General practitioners could play a more important role in mobilizing the population to utilize preventive services. The involvement of general practitioners in the organization of the cervical cancer screening program could increase the participation of those women who generally refuse the services.