Cervical cancer screening in Sri Lanka

Abstract

INTRODUCTION AND OBJECTIVES: To review the performance of the current screening programme for cervical cancer in Sri Lanka. METHODS: The estimated female population over 35 years of age for 2004 to 2009 was obtained from the Department of Census and Statistics. Assuming that 20% of the expected number of women make two visits based on current recommendations, the expected number of visits per year was calculated. The treatment gap was calculated for two scenarios assuming that 10% and 25% of women will seek treatment in the private sector. Assuming that 1% of cervical smears wili be reported as positive, the number of females with changes being missed was calculated. RESULTS: The number of females screened at government institutions has increased from 61,707 in 2004 to 116,415 in 2009. The number of clinics conducted throughout the country increased from 379 to 791. Of the 116,415 females seen for the first time in 2009, cervical visualisation was done in 93,356 (80.2%); among these women pap smears were taken in 85,927 (92.0%) and reports were received for 58,195 (67.7%) women. The treatment gap for cervical cancer screening was over 90% from 2004 to 2009 for both assumptions (10% and 25% of women will receive care in the private sector). The number of women with cytological changes who may be missed by the system is estimated to be almost 10,000 per year. CONCLUSIONS: Based on our simulatio ns, the current screening services for cervical carcinoma are inadequate and needs to be scaled up.