Association of European Cancer Leagues (ECL), Brussels, Belgium.
Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
Eur J Public Health. 2023 Jun 1;33(3):502-508. doi: 10.1093/eurpub/ckad055.
This study aimed to investigate the status of cervical cancer screening (CCS) implementation in Europe by investigating national or regional policies towards broadening coverage of CCS amongst vulnerable subgroups of the population at high risk for CC.
A web-based survey was conducted between September 2021 and February 2022 with CCS programme managers and experts to identify and rank six population subgroups at high risk considered most vulnerable to CC and to map existing policies that addressed the coverage of CCS towards population sub-groups at risk.
A total of 31 responses were received from experts covering 22 European countries. The results of this survey suggest that whilst many countries identify lower coverage of CCS amongst population subgroups at high risk of CC as a public health problem, few countries have developed dedicated policies towards broadening coverage among these subgroups. The six countries who reported having done so were concentrated in the Northern or Western European regions, suggesting the existence of geographical disparities within the continent. A key challenge in this respect is the difficulty to categorize subgroups of the target population; many individuals are burdened by intersectionality thereby resting in multiple categories, which may hinder the effectiveness of interventions targeted to reach specific subgroups.
A greater clarity on the conceptualization of vulnerability can help countries to develop and subsequently implement strategies to increase coverage to subgroups of the target population currently underserved with regards to CCS.
本研究旨在通过调查国家或地区政策,探讨在欧洲扩大宫颈癌筛查(CCS)覆盖范围的现状,以惠及高危人群中易感染宫颈癌的脆弱亚群。
本研究于 2021 年 9 月至 2022 年 2 月期间,通过网络调查了 CCS 项目管理人员和专家,以确定和评估六个高危人群亚组,并对现有政策进行了梳理,以了解这些政策在高危人群亚组的 CCS 覆盖情况。
本研究共收到来自 22 个欧洲国家的 31 名专家的回复。调查结果表明,尽管许多国家将高危人群中 CCS 覆盖率较低视为公共卫生问题,但很少有国家制定了专门针对这些亚组扩大覆盖范围的政策。报告已经采取这一措施的六个国家集中在北欧或西欧地区,这表明该大陆内部存在地域差异。在这方面的一个主要挑战是难以对目标人群的亚组进行分类;许多人因交叉性而受到困扰,从而处于多个类别中,这可能会影响针对特定亚组的干预措施的有效性。
对脆弱性概念的进一步明晰,可以帮助各国制定和实施战略,以增加目前在 CCS 方面服务不足的目标人群亚组的覆盖率。