February 4 is the World Day Against Cancer. This year's campaign motto is "Let's
Create a Future without Cancer. The time to act is now".
From 2012 to 2018, 269 women died of cervical cancer in Macedonia, and in 2020
the state screening program allocates 2.4 million denars less than in 2018, reports
the Association for Emancipation, Solidarity and Equality of Women. – ESE. They
add that, through regular gynecological examinations with a Pap smear, cervical
cancer can be detected in a timely manner and can be fully cured and create a future
without cervical cancer.
The Ministry of Health adopts and implements a Cervical Cancer Screening Program
every year, through which women between the ages of 24 and 60 should undergo a
free PAP test every three years. The screening program is considered successful if it
covers at least 75% of women of a certain age.
In 2018, 52,577 women (9.6% of the target population) were invited through the
Screening Program, while 43,103 women (7.9% of the target population) performed
the PAP test. Although 2018 covers twice as many women as in 2012 [1], it is still
well below the required coverage of 75% of the target population.
The low coverage of women with the Cervical Cancer Screening Program is due
primarily to the low budget. The Ministry allocates 7,670,000 MKD for the 2020
Program and plans to cover only 21,000 women. Worrying is the fact that the budget
for the Program for 2020 is by 2.4 million lower than the budget for the Program for
2018 (when it was 10.080.000 denars). With this type of planning, the Ministry
provides funding to cover only about 11% of the target population.
To increase the coverage of women with the Cervical Cancer Screening Program,
the Ministry of Health should provide 54,383,186 denars [2] annually to enable
coverage of 80% of women aged 24 to 60 years.
An additional problem is the insufficient number of primary gynecologists, ie 158
primary gynecologists are missing in the Primary Health Care. Consequently, over
50% of women have not chosen a gynecologist and cannot be covered by the
Screening Program. Also, not all gynecologists are involved in the implementation of
the Screening Program.
In order to increase the inclusion of women in the Cervical Cancer Screening
Program, other health care providers, such as general and clinical hospitals, as well
as family primary care specialists, should be included in the process of taking PAP
smears. This will overcome the obstacle to the implementation of the Program
resulting from insufficient number of family gynecologists.
For years, both the Ministry of Health and the Fund have been simultaneously
providing preventive activities for early detection of cervical cancer through
gynecological screening with a PAP test, without mutual communication and
coordination.
In order to increase the inclusion of women in the Cervical Cancer Screening
Program, a national cervical cancer screening program should be established, which
will precisely define the criteria and responsibilities of the Ministry of Health and the
Fund for health insurance.
We also inform all women aged 24-60 that they are entitled to free gynecological
examinations with a Pap test once every three years and we urge them to exercise
this right in order to improve their health, ESE reports.
