Implementation of the national program of organized cervical cancer screening in the Republic of Serbia in the period 2013-2024

Abstract

Background: The program of organized cervical cancer screening has been implemented since the end of 2012, i.e. since 2013, in health institutions in the Republic of Serbia and involves actively inviting women to screening and quality control in order to detect cancer or pre-malignant changes and in accordance with the current legal regulations and European guidelines. Additionally, the recommendations of the World Health Organization (Global strategy to accelerate the elimination of cervical cancer as a public health problem) serve as the basis for the inclusion of new institutions and for the development of new models and strategies for improving the program. Methodology and Objectives: The objective of this descriptive study was to present the results from health institutions included in the program of organized cervical cancer screening. Reports from primary health centers for the period from 2013 to 2023 were used as a data source. Results: A total of 1,162,401 women were invited, and about 60% responded to the invitation for screening, of which 629,431 women were tested with the PAP test. There were 37,693 women with a positive PAP test result (about 6%), while the number of performed colposcopies was 47,957 and the number of performed HPV tests was 5,205 (as triage tests). There were 215 pathohistologically confirmed cancers. In 2023 and 2024, proposed changes to the program include the introduction of HPV testing and the inclusion of a larger number of primary healthcare centers, marking progress in the program. Conclusion: The tendency to further improve organized cervical cancer screening involves strengthening and including healthcare institutions, social mobilization, introducing new approaches to screening (HPV test combined with cytology) with the aim of achieving a greater coverage of screening examinations for women in the target population.