Effect of the national screening program on malignancy status of cervical cancer in Northern Thailand
Cervical cancer has posed a serious problem in Thailand for decades. In 2002, a systematic screening program was implemented under universal healthcare coverage for all Thai women. However, there has been little research on how screening affected particular aspects of cervical cancer, such as stage distribution. This screening program has a target group; therefore, it is necessary to assess stage and incidence trends by age of those within and outside the screening target group.
Using trend analysis, we assess in situ and malignant cervical cancers in Northern Thailand to measure changes after implementation of the national screening program.
While incidence of malignant cancers is decreasing and incidence of in situ tumors is increasing across all age groups, women above age 60 still experience a high incidence of malignant tumors.
The screening program is successful in the target group at downshifting the stage distribution of malignant tumors and reducing incidence of malignant tumors with in situ cases being captured. However, the high incidence of malignant tumors in women over age 60 will continue to be clinically relevant for cervical cancer management until younger generations undergoing screening enter this age group.
KeywordsCervical cancer Screening In situ Malignant Thailand
Dr. Sriplung acknowledges the support from the National Research University Fund, Prince of Songkla University (MED580635S). Dr. Virani acknowledges the Fogarty International Center (04R25TW009345).
This study was funded by the National Research University Fund, Prince of Songkla University (MED580635S) and the Fogarty International Center (04R25TW009345).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- Carstensen B, Plummer M, Laara E, Hills M (2013) Epi: a package for statistical analysis in epidemiology. R package version 1.1.49. http://CRAN.R-project.org/package=Epi
- Core Team R (2016) R: A language and environment for statistical computing. R Foundation for Statistical Computing, ViennaGoogle Scholar
- Doll R (1976) Comparison between registries. Age-standardized rates. vol III (IARC Scientific Publications No. 15). International Agency for Research on Cancer, Lyon, FranceGoogle Scholar
- Imsamran W, Chaiwerawattana A, Wiangnon S, Pongnikorn D, Suwanrungrung K, Sangrajrang S, Buasom R (2015) Cancer in Thailand Vol. VIII 2010–2012. Ministry of Public Health, National Cancer nstitute, BangkokGoogle Scholar
- International Health Policy Program TaHIaTAP (2008) Research for Development of an Optimal Policy Strategy for Prevention and Control of Cervical Cancer in Thailand. Ministry of Public Health, BangkokGoogle Scholar
- Khuhaprema T, Srivatanakul P, Sriplung H, Wiangnon S, Sumitsawan Y, Attasara P (2007) Cancer in Thailand Vol. IV 1998–2000. National Cancer Institute, Ministry of Public Health, BangkokGoogle Scholar
- Khuhaprema T, Srivatanakul P, Attasara P, Sriplung H, Wiangnon S, Sumitsawan Y (2010) Cancer in Thailand, Volume V 2001–2003. National Cancer Institute, Ministry of Public Health, BangkokGoogle Scholar
- Ministry of Public Health BoHA (2013) Guidelines for service and development plan for cancer. BangkokGoogle Scholar
- Møller B, Fekjær H, Tryggvadottir L, Storm HH, Talback M, Haldorsen T (2002) Prediction of cancer incidence in the Nordic countries up to the year 2020. Eur J Cancer 11(Suppl 11):S11–S96Google Scholar
- National Statistical Office of Thailand (2010) The 2009 Reproductive Health SurveyGoogle Scholar
- Office of the National Economic and Social Development Board of Thailand (2013) Population Projections for Thailand 2553–2573. http://www.nesdb.go.th/. Accessed 6 May 2013
- 1990 Population and Housing Census (1994) National Statistical Office, BangkokGoogle Scholar
- 2000 Population and Housing Census (2002) National Statistical Office, BangkokGoogle Scholar
- Sangrajrang S (2016) Cervical cancer screening infrastructure in ThailandGoogle Scholar
- Sankaranarayanan R, Wesley RS (2003) A practice manual on visual screening for cervical neoplasia. IARC Technical Publications No 41. International Agency for Research on Cancer, Lyon, FranceGoogle Scholar
- Segi M (1960) Cancer mortality for selected sites in 24 countries (1950–1957). Tohoku University School of Public Health, SendaiGoogle Scholar
- Sriplung H, Singkham P, Iamsirithaworn S, Jiraphongsa C, Bilheem S (2014) Success of a cervical cancer screening program: trends in incidence in Songkhla, Southern Thailand, 1989–2010, and prediction of future incidences to 2030. Asian Pac J Cancer Prev APJCP 15:10003–10008CrossRefPubMedGoogle Scholar
- Tangcharoensathien V LS, Chaugwon R, Praditsitthikorn N, Teerawattananon Y, Tantivess S (2008) Research for the development of an optimal policy strategy for prevention and control of cervical cancer in Thailand. International Health Policy Program and The Health Intervention and Technology Assessment ProgramGoogle Scholar
- Tangcharoensathien V, Patcharanarumol W, Panichkriangkrai W (2016) Health system review: achievements and challenges. World Health Organization c/o Asia Pacific Observatory on Health Systems and PoliciesGoogle Scholar
- Vatanasapt V, Martin N, Sriplung H, Chindavijak K, Sontipong S, Sriamporn S, Parkin DM, Ferlay J (1993) Cancer in Thailand 1988-1991. International Agency for Research on Cancer, LyonGoogle Scholar
- Yothasamut J, Putchong C, Sirisamutr T, Teerawattananon Y, Tantivess S (2010) Scaling up cervical cancer screening in the midst of human papillomavirus vaccination advocacy in Thailand. BMC Health Serv Res 10(Suppl 1):S5. https://doi.org/10.1186/1472-6963-10-S1-S5 CrossRefPubMedPubMedCentralGoogle Scholar