Vuković Vladimir, Štrbac Mirjana, Ristić Mioljub, Skočibušić Siniša, Cilović-Lagarija Šeila, Aćimović Jela, Šiljak Slađana, Živković Perišić Snežana, Nikolić Nataša, Ljubičić Stefan, Pustahija Tatjana, Rajčević Smiljana, Patić Aleksandra, Dugandžija Tihomir, Mandić Aljoša, Petrović Vladimir
Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia.
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Medicina (Kaunas). 2024 Dec 2;60(12):1987. doi: 10.3390/medicina60121987.
: Burden of cervical cancer in Central and Eastern Europe is higher than in other parts of Europe. We analyzed cervical cancer epidemiology in Serbia and Bosnia and Herzegovina (the Federation of Bosnia and Herzegovina and the Republic of Srpska) from January 2016 to December 2020, exploring the role of available sociodemographic factors and healthcare service parameters on incidence and mortality rates, using an ecological approach based on aggregated data. : Incidence and mortality rates are standardized using the method of direct standardization with the World-ASR-W. Administrative units are grouped by tertiles of incidence and mortality to explore sociodemographic factors and healthcare parameters across these groups. : Average age-standardized incidence rates of cervical cancer per 100,000 females were 19.28 in Serbia, 12.48 in the Federation of Bosnia and Herzegovina, and 22.44 in the Republic of Srpska. Mortality rates per 100,000 females were 6.67, 5.22, and 4.56 in Serbia, the Federation of Bosnia and Herzegovina, and the Republic of Srpska, respectively. Several parameters of sociodemographics and health service usage differed significantly across units grouped by tertiles based on incidence level, i.e., female population ≥ 15 years old ( = 0.028), population density ( = 0.046), percent of gynecologists in the primary healthcare ( = 0.041), number of gynecologists per 10,000 females ≥ 15 years ( = 0.007), and the area-to-gynecologist ratio ( = 0.010). A moderate negative correlation was found between incidence and population density (rho = -0.465, = 0.017), and a moderate positive correlation between incidence and area-to-gynecologist ratio (rho = 0.534, = 0.005). : Cervical cancer remains a leading cause of cancer among women in developing countries. Implementing tailored activities, such as educational programs, preventive services, and investments in healthcare infrastructure, particularly at the administrative units' level, can help in reducing health disparities and improving health outcomes.
中欧和东欧的宫颈癌负担高于欧洲其他地区。我们分析了2016年1月至2020年12月塞尔维亚和波斯尼亚和黑塞哥维那（波斯尼亚和黑塞哥维那联邦以及塞族共和国）的宫颈癌流行病学情况，采用基于汇总数据的生态学方法，探究可用的社会人口统计学因素和医疗服务参数对发病率和死亡率的作用。发病率和死亡率采用世界年龄标准化率（World-ASR-W）直接标准化方法进行标准化。行政单位按发病率和死亡率的三分位数分组，以探究这些组中的社会人口统计学因素和医疗参数。塞尔维亚每10万名女性的宫颈癌平均年龄标准化发病率为19.28，波斯尼亚和黑塞哥维那联邦为12.48，塞族共和国为22.44。塞尔维亚、波斯尼亚和黑塞哥维那联邦以及塞族共和国每10万名女性的死亡率分别为6.67、5.22和4.56。根据发病率水平按三分位数分组的各单位之间，社会人口统计学和卫生服务利用的几个参数存在显著差异，即15岁及以上女性人口（p = 0.028）、人口密度（p = 0.046）、初级医疗保健中妇科医生的百分比（p = 0.041）、每10000名15岁及以上女性的妇科医生数量（p = 0.007）以及面积与妇科医生比例（p = 0.010）。发病率与人口密度之间存在中度负相关（rho = -0.465，p = 0.017），发病率与面积与妇科医生比例之间存在中度正相关（rho = 0.534，p = 0.005）。宫颈癌仍然是发展中国家女性癌症的主要原因。开展针对性活动，如教育项目、预防服务以及对医疗基础设施的投资，特别是在行政单位层面，有助于减少健康差距并改善健康结果。
