National Cancer Institute, Department of Medical Services, Ministry of Public Health Rama VI road, Ratchathewi Bangkok 10400, Thailand.
Asian Pac J Cancer Prev. 2021 Jan 1;22(1):25-30. doi: 10.31557/APJCP.2021.22.1.25.
Cervical cancer is an important public health problem in Thailand. It was the most common cancer in Thai women with the incidence rate of 23.4 per 100,000 women in 1990.
The aim of this study was to share the experiences and summary the outcome of cervical cancer screening program in Thailand.
The Ministry of Public Health in cooperation with the National Health Security Office, launched the National Cervical Cancer Screening Program, covering 76 provinces nationwide under Universal Coverage Scheme in 2005. The screening method are Pap smear and Visual Inspection with Acetic acid (VIA) for women aged 30-60 and 35-45 respectively with a 5-year screening interval. Detecting cervical pre-cancerous lesions will follow by day care treatment such as cryotherapy, Loop Electrosurgical Excision Procedure, etc. Results: The first phase (2005-2009), was carried out on 3,124,855 women, the coverage reached 77.5%. For the second phase (2010-2014), 7,637,226 women were screened, reaching 53.9% coverage of target women. However, we have few data of follow up examination after abnormal screening. Therefore, we conducted new system to get more follow up data in 2019. Under the coordination of many related partners, 10,762,081 women have been screened during 2005-2014. The incidence rate declined to 11.7 per 100,000 women which is ranked as the third most common in women in 2014.
This article briefly reviews the challenge of implementing an efficient cervical cancer screening in Thailand. In 2020, HPV testing has been introduced as a primary screening test for all Thai women attending public health sector instead of conventional Pap test.
宫颈癌是泰国一个重要的公共卫生问题。1990 年，泰国女性中发病率最高的癌症是宫颈癌，发病率为每 10 万人 23.4 例。
本研究旨在分享泰国宫颈癌筛查计划的经验并总结其结果。
2005 年，公共卫生部与国家健康保障办公室合作，在全民医保计划下在全国 76 个省启动了国家宫颈癌筛查计划。筛查方法为 30-60 岁女性采用巴氏涂片法，35-45 岁女性采用醋酸视觉检查法（VIA），筛查间隔为 5 年。发现宫颈癌前病变后，可采用冷冻疗法、环电切除术等日间护理治疗。
第一阶段（2005-2009 年），共对 3124855 名妇女进行了筛查，覆盖率达到 77.5%。第二阶段（2010-2014 年），对 7637226 名妇女进行了筛查，目标妇女覆盖率达到 53.9%。然而，我们对异常筛查后的后续检查数据较少。因此，我们在 2019 年建立了新的系统以获取更多的后续数据。在许多相关合作伙伴的协调下，2005-2014 年期间，共有 10762081 名妇女接受了筛查。宫颈癌发病率下降至每 10 万人 11.7 例，在 2014 年女性中排名第三。
本文简要回顾了在泰国实施高效宫颈癌筛查所面临的挑战。2020 年，HPV 检测已被引入作为所有接受公共卫生部门服务的泰国女性的主要筛查检测方法，取代了传统的巴氏涂片检测。
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