Relaunching of the National Program on Cervical Cancer Prevention: main strategies and future challenges

ARROSSI S; LAUDI R; GONZALEZ PRIETO G

Congreso; 2010 World Cancer Congress; 2010

Background: In Argentina, cervical cancer prevention programs have been introduced piecemeal, they lack quality control systems and information systems to monitor their actual impact. In 2007 the Ministry of Health (MoH) initiated a project to improve and strengthen cervical cancer prevention activities, whose first phase was a situational analysis of prevention strategies developed in the 24 provinces of the country to identify its main pitfalls and limitations; Based on the results of the situational analysis, the MoH re-launched in 2008 the National Program on Cervical Cancer Prevention, focusing on the five provinces with the country’s highest mortality rates (Misiones, Formosa, Chaco, Jujuy and Salta). Objectives: To develop an organized program that is effective in reducing cervical cancer incidence and mortality. Goals for the period 2008-2011 in the selected five provinces are: achieving 60% Pap coverage of women aged 35-64, treating 100% of women with precancerous lesions within 6 months of diagnosis, incorporating quality control procedures in cytology laboratories, and implementing information systems. Methods: Main strategies to achieve these goals include: a) Establishing context-specific agreements between the national and provincial MoHs: in such, responsibilities, and commitments for provision of economic and human resources are established; b) Involving health services and professionals in the development of key program components through strategic planning. c) Strengthening of health services and coordination between them. d) Carrying out pilot projects; e) Promoting health services that are responsive to women’s needs, promoting active search and optimizing opportunistic screening. f) Implementing quality-control procedures as well as monitoring and information systems. Results: By December 2009, participatory diagnosis have been carried out in all five provinces, agreements have been signed in three provinces, and equipment has been provided to cytology laboratories and treatment services. Smallscale pilot-projects have been implemented in four provinces. An on-line information system was installed in cytology laboratories from five provinces. A national training center for cytotechnicians was implemented. Continuous communication, education and training activities both for the community and health professionals have been developed. A key training strategy is to promote the scientific basis of cervical cancer prevention among health professionals: the first International Seminar on “Organization, Quality Control and Evaluation of a cervical cancer prevention program”, was carried out in April 2009, with support from UICC and PAHO. Conclusions: In Argentina, re-launching the National Program on Cervical Cancer Prevention is a main step to detect and treat pre-cancerous lesions, contributing to the achievement of Target 6 of the World Cancer Declaration. Major challenges for next years are to evaluate the impact of the National Program, to ensure the political and technical sustainability of proposed activities, extending activities to the other provinces, and developing pilot projects to evaluate the local feasibility of introducing new prevention technologies.In Argentina, cervical cancer prevention programs have been introduced piecemeal, they lack quality control systems and information systems to monitor their actual impact. In 2007 the Ministry of Health (MoH) initiated a project to improve and strengthen cervical cancer prevention activities, whose first phase was a situational analysis of prevention strategies developed in the 24 provinces of the country to identify its main pitfalls and limitations; Based on the results of the situational analysis, the MoH re-launched in 2008 the National Program on Cervical Cancer Prevention, focusing on the five provinces with the country’s highest mortality rates (Misiones, Formosa, Chaco, Jujuy and Salta). Objectives: To develop an organized program that is effective in reducing cervical cancer incidence and mortality. Goals for the period 2008-2011 in the selected five provinces are: achieving 60% Pap coverage of women aged 35-64, treating 100% of women with precancerous lesions within 6 months of diagnosis, incorporating quality control procedures in cytology laboratories, and implementing information systems. Methods: Main strategies to achieve these goals include: a) Establishing context-specific agreements between the national and provincial MoHs: in such, responsibilities, and commitments for provision of economic and human resources are established; b) Involving health services and professionals in the development of key program components through strategic planning. c) Strengthening of health services and coordination between them. d) Carrying out pilot projects; e) Promoting health services that are responsive to women’s needs, promoting active search and optimizing opportunistic screening. f) Implementing quality-control procedures as well as monitoring and information systems. Results: By December 2009, participatory diagnosis have been carried out in all five provinces, agreements have been signed in three provinces, and equipment has been provided to cytology laboratories and treatment services. Smallscale pilot-projects have been implemented in four provinces. An on-line information system was installed in cytology laboratories from five provinces. A national training center for cytotechnicians was implemented. Continuous communication, education and training activities both for the community and health professionals have been developed. A key training strategy is to promote the scientific basis of cervical cancer prevention among health professionals: the first International Seminar on “Organization, Quality Control and Evaluation of a cervical cancer prevention program”, was carried out in April 2009, with support from UICC and PAHO. Conclusions: In Argentina, re-launching the National Program on Cervical Cancer Prevention is a main step to detect and treat pre-cancerous lesions, contributing to the achievement of Target 6 of the World Cancer Declaration. Major challenges for next years are to evaluate the impact of the National Program, to ensure the political and technical sustainability of proposed activities, extending activities to the other provinces, and developing pilot projects to evaluate the local feasibility of introducing new prevention technologies.