REVIEW – November 2009

Screening for cervical cancer in Estonia: organisation and results



BACKGROUND. Cervical cancer is the second gynaecological malignancy among women in Estonia. A pilot project on screening for cervical cancer, financed by the Estonian Health Insurance Fund was launched in 2003. From 2006 onwards this project can be considered a national cervical cancer screening programme. Screening for cervical cancer is targeted to women aged 30–55 and Pap-tests are taken with an interval of 5 years. Women are invited for screening using invitation letters sent by post. However, national screening does not yet involve uninsured women.

AIM. This article provides an overview of the organisation of the screening for cervical cancer, women’s awareness of cervical screening and screening results in the period 2003–2008.

METHOD. The overview was compiled using data on health insurance, data collected by the Cancer Screening Union, and national health statistics. The awareness of women  of screenings was studied in an omnibus survey in 2008.

RESULTS. Over the period 2003–2008 a total of 48 987 women were involved in screening for cervical cancer. Despite the high level of awareness among women, the participation rate is still quite low: only one woman of three who received the invitation has participated in screening. Precancerous conditions were detected in 5.6% of the women who participated in screening and over 30 cases of cervical cancer were found during the above mentioned period.

CONCLUSIONS. As screening for cervical cancer has taken place during a relatively short period in Estonia, it has not yet had an effect on the morbidity and mortality in target populations. Available datasets do not allow to evaluate the real impact of screening on the morbidity and mortality of cervical cancer. There exists a continuing need to establish a screening registry.