Poland expands prevention screening programs

1 year ago 48

As of 1 November, a broader group of Polish women will have access to preventive screenings for the early detection of breast and cervical cancer, but experts warn that more should be done.

Breast cancer is the most prevalent malignancy among women, and its risk increases with age. In Poland, approximately 20,000 women are diagnosed with breast cancer annually.

Early detection is crucial, whether through monthly self-examinations, breast ultrasounds, or mammography, as it enhances the chances of successful treatment.

Starting from 1 November, the screening programs – mammography and cytology – will be expanded.

The free mammography program has been recently expanded to include women between the ages of 45 and 74.

Eligibility is based on whether they have undergone this type of diagnostic screening in the last 24 months or have received written recommendations for more frequent screenings due to risk factors. Until now, screening mammography was available for women aged 50-69.

Professor Mariusz Bidzinski, the national consultant in gynecologic oncology, expressed his support for these changes: “From an epidemiological as well as demographic public point of view, this change in the cancer prevention system is the right way to go.”

Furthermore, in early January, women with a previous breast cancer diagnosis can participate in the program annually if they have completed their treatment and the 5-year monitoring period.

Alternatively, if they have not finished their treatment but are receiving supplementary hormone therapy (HT) five years after surgical breast cancer treatment.

In parallel, significant changes are occurring in the cervical cancer prevention program. Previously, free cytology screenings were accessible to women aged 25-59. As of 1 November, the program will be extended to include women between the ages of 25 and 64.

Cervical cancer is detected in approximately 3,000 Polish women annually and constitutes over 10% of all gynaecological cancers. To meet the preventive examination objectives, a cytology exam should be performed at intervals of no longer than every three years, assuming there is no elevated risk of cervical cancer and previous test results are normal.

Annual testing is recommended for high-risk women or those with a history of abnormal cytology results.

Referrals are not required for preventive mammography and cytology, and both diagnostic examinations are funded by the National Health Fund (NFZ).

Health Minister Katarzyna Sójka announced that these decisions were made following consultations with healthcare professionals and patient organisations.

These changes, she emphasised, aim to increase the number of people benefiting from preventive screenings, thereby leading to earlier cancer diagnoses.

Screening programmes’ shortcomings

However, funding covers only traditional cytology. Thin-layer cytology (LBC), offering higher diagnostic sensitivity and the capability to further examine collected material for the presence of the Human Papillomavirus (HPV), remains a paid service.

“Liquid-based cytology provides fewer false negative readings and enables further examination of the collected material for HPV virus presence,” professor Mariusz Zimmer, PTGiP president, emphasised.

For Dr Bidziński, the main challenge is motivating Polish women to undergo regular preventive screenings.

“Regardless of whether we use traditional or modern methods, if invitations are frequently ignored, it’s hard to talk about the effectiveness of preventive screenings. Currently, less than 20% of the population participates in cytological tests,” he explained to Euractiv.

Bidziński also stressed that broad organisational changes are needed to encourage more women to participate in preventive examinations.

“Examples of issues that need systemic solutions include communication exclusion and the involvement of not only physicians but also midwives who could perform cytology tests, thus relieving the healthcare system,” he said.

Vaccinations

Primary prevention is another vital aspect, particularly regarding cervical cancer.

HPV vaccinations are highly effective when administered before potential exposure to HPV, primarily through sexual contact.

In Poland, free HPV vaccinations have been available to boys and girls aged 12 to 13 since 1 June 1 this year. Furthermore, as of 2 September, the bivalent HPV vaccine is now accessible for all children aged 9 to 18.

“This is a significant step forward,” Dr Bidziński noted.

“However, only then can we expect that, over several years, perhaps a decade or more, the cervical cancer problem will be resolved”, he concluded.

(Paulina Mozolewska – Edited by Vasiliki Angrouridi/Zoran Radosavljevic | Euractiv.com)