Cervical cancer burden, status of implementation and challenges of cervical cancer screening in Association of Southeast Asian Nations (ASEAN) countries. (28th January 2022)

• Record Type: Journal Article
• Authors: Zhao, Shuang; Huang, Liuye; Basu, Partha; Domingo, Efren Javier; Supakarapongkul, Wisit; Ling, Woo Yin; Ocviyanti, Dwiana; Rezhake, Remila; Qiao, Youlin; Tay, Eng Hseon; Zhao, Fanghui
• Is Part Of: Cancer letters. Volume 525(2022)
• Page Start: 22
• Page End: 32
• Publication Date: 2022-01-28
• Subjects: HPV -- Cervical cancer burden -- Screening -- Challenge -- ASEAN; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Electronic journals; 616.994
• DOI: 10.1016/j.canlet.2021.10.036
• Languages: English
• ISSNs: 0304-3835

Abstract

Abstract: Multiple barriers impede the transformation of evidence-based research into implementation of cervical cancer screening in ASEAN countries. This review is the first of its kind to show the disease burden of cervical cancer, progress till date to implement screening and corresponding challenges, and propose tailored solutions to promote cervical cancer prevention in ASEAN. In 2020, approximately 69 000 cervical cancer cases and 38 000 deaths happened in ASEAN, and more than 44% and 63% increases on new cases and deaths are expected in 2040. Only four countries have initiated population-based cervical cancer screening programs, but the participation rate is less than 50% in some countries and even lower than 10% in Myanmar and Indonesia. Inequity and unavailability in service delivery, lack of knowledge and awareness, limited follow-up and treatment capacity, and funding sustainability affect successful scale-up of cervical cancer screening most in ASEAN. Implementing HPV detection-based primary screening, appropriate management of screen-positives, enhancing health education, integrating health services can accelerate reduction of cervical cancer burden in ASEAN. Achieving high screening coverage and high treatment compliance will help ASEAN countries remain aligned to cervical cancer elimination strategies. Highlights: Cervical cancer burden is high and rapidly increasing in ASEAN, hence need for comprehensive screening. Four countries have initiated population-based cervical cancer screening programs but screening coverage remains low. Service delivery, knowledge, awareness, follow-up, treatment, and funding sustainability affect scale-up of screening in ASEAN. Implementing self-sampling, HPV test primary screening, screen-and-treat and health education, integrating health services can promote cervical cancer screening and control in ASEAN.