On the 17th of November 2021, the day we marked the first year of the Cervical Cancer Elimination movement, the 11th Educational day of the National Cervical Cancer Screening Programme ZORA was held. The educational day was held vritually and more than 600 gynaecologists, nurses, cytopathologists, histopathologists, epidemiologists and other collaborators of the National Cervical Cancer Screening Programme ZORA joined this day.
The participants were greeted by Mojca Gobec from The Public Health Directorate, Director General of the Health Insurance Institute of Slovenia Tatjana Mlakar, Medical Director of the Institute of Oncology Ljubljana Irena Oblak, head of WHO Country Office in Slovenia Aiga Rurane and head of National Cervical Cancer Screening Programme and Registry ZORA Urška Ivanuš.
Welcoming speakers of the 10th Educational day of the National Cervical Cancer Screening Programme ZORA
In the first section lecturers presented the operation and results of the National Cervical Cancer Screening Programme ZORA during COVID-19 pandemics, future plans and cervical cancer screening participation determinants. Lecterures presented the report of the study of implementation of liquid based technology in Slovenia and contemporary molecular methods in cervical cancer screening.
In the second section the ZORA programme Guidelines were presented. We also had the chance to listen to the presentation of two other screening programmes in Slovenia – programme DORA and Svit. Case report presenting discrepancies in a young woman's cytological and pathologycal tests was also presented.
In the third section Vitaly Smelov from the European office of the WHO joined us and shared a few words about how to overcome disparities on Europe’s path to cervical cancer elimination. Carmen Ungurean, Cancer Screening Coordinator at the National Institute of Public Health in Romania, presented the challanges Romania is facing on it's path to cervical cancer elimination. Next lectures were about HPV vaccination, both case reports and study reports. HPV vaccination impact in Slovenia was also presented.
Two key messages from 11th Educational day of the National Cervical Cancer Screening Programme ZORA:
- The first national study on HPV vaccination impact showed results on a population-level. At the Institute of Oncology Ljubljana, we analysed the routinely collected data within ZORA Registry. Data showed that generations of girls that had an opportunity to vaccinate within the national HPV vaccination programme are half less likely to be diagnosed with precancerous cervical changes at screening, compared to past generations, for which vaccination was not yet available. Since the vaccine coverage in Slovenia increased with time, we expect even greater differences between vaccinated and unvaccinated generations in the future.
- During a two-month screening lock-down in at the beginning of the pandemic, cervical cancer screening was at a halt, but already on May 11th 2020 screening programme became fully operational again and didn't stop since then. Due to the COVID-19 pandemic, the examination coverage of the target population of the national cervical cancer screening programme ZORA decreased below 70% in the last 3-year period (1 July 2017−30 June 2020). However, immediately after the resumption of screening, we noticed a higher volume of cervical smear results compared to previous years (by more than 20%) and at the end of the summer 2020, coverage increased above 70 % again. Despite that, we exited year 2020 with a 10 % pandemic deficit of screening smears and 14 % deficit in a detection of high-grade cervical lesions CIN2+, mostly in women 30-39 years old. In the beginning of 2021 we didn't observe any deficits compared to the pre-pandemic period, however at the beginning of summer we observed less screening smears in younger woman again that led to a 12 % cumulative deficit of CIN2+ in age group 30-39 years the middle of the summer 2021. ZORA programme management has already responded with press release, feedback to screening providers and a survey to identify the new pandemic barriers in young women.
The National Cervical Cancer Screening Programme ZORA would like to than everyone who was a part of this great day.
Until next year!
National Cervical Cancer Screening Programme ZORA team
