Browsing by Author "Perisic, Zivko (56610624400)"

Purpose: The aim of this study was to analyze trends of death rates for cervical cancer (CC) on territory of The Re-public of Serbia in the period 1991-2011. Methods: In this descriptive epidemiological study, unpublished data of the Statistical Office of the Republic of Serbia were used for the analysis of mortality due to CC among women in Serbia, from 1991 to 2Oil. Three different types of rates were calculated: crude, age-specific and age-adjusted rates. The age-standardized rates were calculated by the direct method of standardization using the World Standard Population as standard. The trends were assessed by joinpoint linear regression analysis. An average annual percentage change (AAPC) and the corresponding 95% confidence intervals (CI) were computed for screening programs has dramatically reduced the mortality rates of CC [3]. Based on the information presented by the International Agency for Research on Cancer (IARC) in 2012, Serbia is in the third place for the mortality, after Romania and Moldova [4]. According to unpublished data of the Cancer Registry of the Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", in 2011, the CC standardized mortality rate was 6.9 per 100,000 women [5]. With contribution of 5.5% in central trends. Results: The average age-standardized CC mortality rate (ASCCMR) was 7.03 per 100,000. The lowest value of the ASCCMR was at the beginning of the observed period (6.05 per 100,000) and the highest was 8.17 per 100,000 in 2008. The age-adjusted CC mortality rates have been continuously and significantly increasing (AAPC=+0.7, 95% CI=0.3- 1.1, p<0.05). In all age groups we found increasing trends, except in the age group of 65-74 years. Conclusion: Since ASCCMR has been steadily increasing during the period observed, reducing these rates is highly warranted. To achieve this target, an organized CC screening program is essential.

Purpose: The aim of this study was to analyze trends of death rates for cervical cancer (CC) on territory of The Re-public of Serbia in the period 1991-2011. Methods: In this descriptive epidemiological study, unpublished data of the Statistical Office of the Republic of Serbia were used for the analysis of mortality due to CC among women in Serbia, from 1991 to 2Oil. Three different types of rates were calculated: crude, age-specific and age-adjusted rates. The age-standardized rates were calculated by the direct method of standardization using the World Standard Population as standard. The trends were assessed by joinpoint linear regression analysis. An average annual percentage change (AAPC) and the corresponding 95% confidence intervals (CI) were computed for screening programs has dramatically reduced the mortality rates of CC [3]. Based on the information presented by the International Agency for Research on Cancer (IARC) in 2012, Serbia is in the third place for the mortality, after Romania and Moldova [4]. According to unpublished data of the Cancer Registry of the Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", in 2011, the CC standardized mortality rate was 6.9 per 100,000 women [5]. With contribution of 5.5% in central trends. Results: The average age-standardized CC mortality rate (ASCCMR) was 7.03 per 100,000. The lowest value of the ASCCMR was at the beginning of the observed period (6.05 per 100,000) and the highest was 8.17 per 100,000 in 2008. The age-adjusted CC mortality rates have been continuously and significantly increasing (AAPC=+0.7, 95% CI=0.3- 1.1, p<0.05). In all age groups we found increasing trends, except in the age group of 65-74 years. Conclusion: Since ASCCMR has been steadily increasing during the period observed, reducing these rates is highly warranted. To achieve this target, an organized CC screening program is essential.

Purpose: To evaluate the process indicators for monitoring the Organized Cervical Cancer Screening Programme (OC-CSP) conducted in the Belgrade municipality of Cukarica within the first three-year interval, and to compare Pap test coverage for women aged 25 to 64 before and after implementing the organised programme. Methods: We analyzed the coverage by invitation, compliance with invitation and coverage by Pap test for the first three-year interval of the OCCSP (20th' Dec 2012 -19th Dec 2015) as well as the results of opportunistic screening for the same period and coverage by Pap test for women aged 25 to 64 for the last three years prior to the implementation of the OCCSP. Results: After the first three years of the OCCSP implementation, coverage by invitation was 42.9%, compliance to invitation 66.7% and coverage by Pap test was 28.6%. During the same period, outside of the program (opportunistic screening) coverage by Pap test was 9.4%. In the last three years prior to the implementation of the OCCSP coverage by Pap test for women aged 25 to 64 was 21.4%. Conclusion: After the first three-year interval of the OCCSP implementation, the overall (organised + opportunistic) Pap test coverage for women aged 25-64 has almost doubled compared to the period when we conducted exclusively opportunistic screening (38.4 vs 21.4%). However, incentive payment for the smear takers and better coordination and planning of capacity-building is needed in order to achieve the 75% Pap tests coverage recommended by the National Programme for Early Detection of Cervical Cancer.

Purpose: To evaluate the process indicators for monitoring the Organized Cervical Cancer Screening Programme (OC-CSP) conducted in the Belgrade municipality of Cukarica within the first three-year interval, and to compare Pap test coverage for women aged 25 to 64 before and after implementing the organised programme. Methods: We analyzed the coverage by invitation, compliance with invitation and coverage by Pap test for the first three-year interval of the OCCSP (20th' Dec 2012 -19th Dec 2015) as well as the results of opportunistic screening for the same period and coverage by Pap test for women aged 25 to 64 for the last three years prior to the implementation of the OCCSP. Results: After the first three years of the OCCSP implementation, coverage by invitation was 42.9%, compliance to invitation 66.7% and coverage by Pap test was 28.6%. During the same period, outside of the program (opportunistic screening) coverage by Pap test was 9.4%. In the last three years prior to the implementation of the OCCSP coverage by Pap test for women aged 25 to 64 was 21.4%. Conclusion: After the first three-year interval of the OCCSP implementation, the overall (organised + opportunistic) Pap test coverage for women aged 25-64 has almost doubled compared to the period when we conducted exclusively opportunistic screening (38.4 vs 21.4%). However, incentive payment for the smear takers and better coordination and planning of capacity-building is needed in order to achieve the 75% Pap tests coverage recommended by the National Programme for Early Detection of Cervical Cancer.

Purpose: To investigate the psychological effects of PAP smear and colposcopy performed simultaneously and receipt of abnormal tests' results on women's well-being and quality of life (QoL) using different relative questionnaires. Methods: A prospective cohort study included 324 women with abnormal PAP smear result obtained at the primary care centers, requiring repeat smear test and colposcopy in our hospital. Questionnaires regarding the patient demographic characteristics, 7-point Likert scales which indicate concern about the smear and colposcopy results and risk of developing cervical cancer, Bek Anxiety Inventory (BAI), European QoL questionnaire - Euro QoL (EQ-5D) and visual analogue scale (EQ VAS) were used. Women filled in the questionnaires at the pre-procedural assessment, and again, 7-10 days after testing, just after the reception of results. Results: According to BAI scale, almost one-quarter of women (23.5%) showed mild to severe anxiety; higher level of anxiety had women with abnormal test results (p=0.008). After adjustment for age, the difference reached statistical significance in the follow up period, too (p<0.05). At the pre-procedural assessment, there was no significant difference in the concern about test results (4.09 vs 4.22) and the perceived risk of developing cervical cancer (3.99 vs 4.14) using self-assessment by the Likart scales. However, women with abnormal test results had lower quality of life compared to women with normal PAP smear and colposcopy (mean EQ-VAS score 77.35 ± 15.63 vs 81.14 ± 16.07; p=0.020). Conclusions: We conclude that referral for evaluation after a first abnormal PAP test leads to anxiety. Close and clear communication about test meaning and its consequences is needed in the organized screening test.

Purpose: To investigate the psychological effects of PAP smear and colposcopy performed simultaneously and receipt of abnormal tests' results on women's well-being and quality of life (QoL) using different relative questionnaires. Methods: A prospective cohort study included 324 women with abnormal PAP smear result obtained at the primary care centers, requiring repeat smear test and colposcopy in our hospital. Questionnaires regarding the patient demographic characteristics, 7-point Likert scales which indicate concern about the smear and colposcopy results and risk of developing cervical cancer, Bek Anxiety Inventory (BAI), European QoL questionnaire - Euro QoL (EQ-5D) and visual analogue scale (EQ VAS) were used. Women filled in the questionnaires at the pre-procedural assessment, and again, 7-10 days after testing, just after the reception of results. Results: According to BAI scale, almost one-quarter of women (23.5%) showed mild to severe anxiety; higher level of anxiety had women with abnormal test results (p=0.008). After adjustment for age, the difference reached statistical significance in the follow up period, too (p<0.05). At the pre-procedural assessment, there was no significant difference in the concern about test results (4.09 vs 4.22) and the perceived risk of developing cervical cancer (3.99 vs 4.14) using self-assessment by the Likart scales. However, women with abnormal test results had lower quality of life compared to women with normal PAP smear and colposcopy (mean EQ-VAS score 77.35 ± 15.63 vs 81.14 ± 16.07; p=0.020). Conclusions: We conclude that referral for evaluation after a first abnormal PAP test leads to anxiety. Close and clear communication about test meaning and its consequences is needed in the organized screening test.