UICC World Cancer Congress 2006

Objective:Though mortality from cervical cancer is decreasing in most European countries, in Eastern areas rates are still elevated. Moreover in BiH the recent conflict has had a severe impact on the capacity of the medical system. This project rose in the framework of an international cooperation between Italian public institutions/NGOs and the municipality of Breza with the following aims: to screen with a Pap-smear the women resident in Breza and aged 25-64; to build professional capacity in Bosnian health operators; to make women living in a post war setting more aware about cancer prevention. Methods:The project started in September 2003 in close cooperation with the local health and community authorities. The recruitment strategy was based both on personal invitation letters and on women's sensitization by specifically trained midwives who met those living in uncomfortable rural areas. Results:From September 2003 to December 2004, 1540 women have been invited by letters with a response rate of 64.1%. Other 1134 women spontaneously contacted the screening unit to perform the test. 1984 smears have been undertaken and 203 (10.2%) ended with a positive cytology results: 73.9% LSIL, 20.2% HSIL, 5.9% carcinoma. The invasive carcinomas have been histologically confirmed with a detection rate of 6 ‰. Conclusions: Although the high amount of spontaneous participation, the detection rate of invasive lesions resulted more than 20 times higher than the corresponding rate in established screening programme in Western Europe. This can be due both to the high basic incidence and to the background context.