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CERVICAL CANCER CLUSTERING IN ARAD AND CERVICAL CANCER SCREENING PROGRAMMES IN ROMANIA
Abstract
Cervical cancer is a major worldwide health problem that can be prevented by using a simple exam, a cervical-vaginal cytology or Pap smear. Romania has the highest incidence of and mortality from cervical cancer in Europe. Romanian people have a strong fear towards cancers and, paradoxically, toward screening measures for cancer. Objectives: To determine the efficiency of Romanian Health Programmes regarding cervical cancer. Materials and Methods: The last six decennial periods were analysed from the point of view of registered cervical cancers cases, using all available types of official statistical data for Arad County region of Romania (n=2333, between 1957- 2017) and spatial cluster analysis method to evaluate if there is particular location in the region where events tend to aggregate. Factor analysis extracted three factors, labeled as: „Age category incidence”, „Stages of cancer” and „Relative Risk of cancer in different age category”. Results: Depending on specified k number of cervical cancers there were 25 cervical cancer cluster in Arad region. Incidence of cervical cancer for Arad region is the greatest for aged 40-49 years, which is surprisingly in general context where the peak age of cancer diagnosis is population aged 25–29 years, Relative Risk of cervical cancers for this age category being four times higher compared to those aged under 40 years and one and a half times more than those aged over 50 years. Cytologybased cervical cancer diagnosis also showed advanced cervical cancers stages at the diagnosis moment and the presence of a higher numbers of so called rare subtypes of cervical cancers. Conclusion: Cervical cancer control in Romania needs imperative actions to be taken, focused mainly on the highest risk age-categories and on building a positive attitude about cancer screening, knowing that a positive attitude is never automatic. Recommendation: To perform an in depth analysis of this phenomenon for a set of suitable measures to define and implement.
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