Percent of women 30-49 who have been screened at least once for cervical cancer
The percent of women aged 30-49 who have been screened at least once for cervical cancer. “Screening” is defined as a public health intervention used on a population at risk, or target population. Screening is not undertaken to diagnose cervical cancer, but to identify women with a high probability of having or developing it. Screening methods can include cytology (Pap smear), HPV DNA, or visual methods.
This indicator is calculated as:
(Number of women 30-49 who have been screened at least once for cervical cancer / Total number of women surveyed) x 100
Woman’s age; response to question asking woman if she has been screened at least once for cervical cancer
Special survey; DHS and RHS
Within a national cancer control program, the four basic components of cervical cancer control are: primary prevention, early detection, diagnosis and treatment, and palliative care. This indicator is related to early detection, which includes organized screening programs targeting the appropriate age group.
In resource-poor settings, 30-49 year old women comprise the target audience because cervical cancer is rare in women under 30 and most common in women over 40 years. Screening younger women will detect many lesions that are not likely to develop into cancer, will lead to considerable overtreatment, and is not cost-effective. New programs should start by screening women aged 30 years or more, and include younger women only when the higher-risk group has been covered. If a woman can be screened only once in her lifetime, the best age is between 35 and 45 years (WHO, 2006).
Cervical cancer screening aims to detect precancerous changes, which, if not treated, may lead to cancer. But screening services are only effective if there is a well-organized system for follow-up and treatment. Thus, women who are found to have abnormalities on screening need follow-up, diagnosis, and possibly treatment (for pre-cancerous lesions treatment should be done at the time of screening) in order to prevent the development of cancer or treat cancer at an early stage (WHO, 2006).
This indicator does not assess the quality of the screening procedure, if the client received appropriate information and counseling, or if the woman was informed of her test results. The indicator also does not reveal if follow-up and management were provided for those with positive screening results. Efforts to increase coverage are wasted when those who test positive are not followed up appropriately. Therefore, this indicator should be complimented with the indicator, “Percent of screened positive women who have received treatment”.
access, sexually transmitted infection (STI), cervical cancer
WHO. Comprehensive cervical cancer control : a guide to essential practice. Switzerland, 2014. http://www.who.int/reproductivehealth/publications/cancers/cervical-cancer-guide/en/