Keyword: Cervical Cancer

ABSTRACT: Introduction: Cervical cancer remains a significant problem in the structure of cancer morbidity and mortality among women in the Republic of Tajikistan. During the period from 2014 to 2025, the average age-standardized incidence rate (ASIR) was 11.68 per 100,000 female population, and the age-standardized mortality rate (ASMR) was 6.80 per 100,000. The highest average age-specific incidence rates were recorded in the 55–64 age group, at 32.16 per 100,000 women. To reduce this burden and in line with the World Health Organization's Global Strategy for the Elimination of Cervical Cancer, the Government of Tajikistan officially launched a mass human papillomavirus (HPV) vaccination campaign in October 2025. Objective: To evaluate the initial results of the implementation, coverage, safety profile, and public perception of the first national HPV immunization campaign targeting adolescent girls aged 10–14 years in the Republic of Tajikistan.
Materials and Methods: Following the vaccination campaign conducted in October 2025, a comprehensive assessment was carried out. The study analyzed official statistical data from the Republican Center for Immunoprophylaxis, covering a target population of 542,268 girls. In December 2025, a formal Post-Introduction Evaluation (PIE) was conducted at 16 immunization centers and 22 medical facilities to assess logistics, cold chain management, and healthcare worker preparedness. In addition, Rapid Convenience Monitoring (RCM) was implemented in 140 schools across 28 districts for operational decision-making, during which 8,834 girls were interviewed using structured teacher-administered questionnaires to identify behavioral and social factors influencing vaccination.
Results: The overall coverage of the national campaign reached 95.5%, with 507,114 girls vaccinated. Specifically, coverage was 91.1% among the cohort of 10-year-old girls (routine vaccination) and 96.7% among the cohort aged 11–14 years (catch-up vaccination). The vaccine safety profile was excellent, with 48 minor adverse events following immunization (AEFI) reported, accounting for 0.009%. The school-based RCM survey confirmed high coverage rates (91.5% in surveyed schools) and demonstrated strong public support, with 81% of parents endorsing the initiative. The main barriers among the unvaccinated minority were parental refusal (17.0%) and absence from school on the day of vaccination (16.3%). PIE results highlighted strong political leadership, a reliable cold chain infrastructure, and effective interaction between parents and educators, although minor local vaccine supply delays were also noted.
Conclusion: The rapid integration and exceptionally high vaccination coverage against HPV mark a critical public health achievement for Tajikistan. The first national campaign has successfully laid the foundation for achieving international cervical cancer elimination targets. To sustain the results achieved, future efforts should focus on local microplanning, continued community awareness initiatives to address vaccine hesitancy, and ensuring reliable supply chains for routine immunization.

ABSTRACT: Objective: To evaluate the medical-organizational and clinical effectiveness of optimizing comprehensive diagnostics and follow-up care for patients with cervical intraepithelial neoplasia (CIN) through the introduction of a specialized digital module into the national Health Management Information System (HMIS/DHIS2) of the Republic of Tajikistan.
Materials and Methods: An analysis was conducted on the results of diagnosis, treatment, and dynamic follow-up of 542 patients with morphologically verified CIN1–3/Tis, aged 20 to 65 years, examined during 2023–2026. The main group using the digital system (n=82) was compared with a control group managed through paper-based documentation (n=460). The developed Digital Module for Early Diagnosis (DMED) of cervical cancer enabled the integration of 51 specialized cervical pathology units at district and city health centers, HPV diagnostics laboratories, cytology laboratories, and the State Institution "Republican Oncological Scientific Center" (ROSC). Time intervals for completing stages of medical care and the proportion of patients under follow-up care were assessed.
Results: The use of automatic tracking algorithms through the DMED for cervical cancer reduced the total diagnostic and treatment time interval (from abnormal visual screening through extended diagnostics to organ-preserving treatment with LEEP/cone biopsy) from 68.4 ± 5.2 to 21.2 ± 2.4 days (p < 0.001). The proportion of women lost to follow-up decreased from 34.2% to 6.1%. All 5 cases of invasive cervical cancer detected using the DMED were diagnosed at stage I of the disease.
Conclusion: The implementation of the DMED for cervical cancer optimizes the organization of gynecologic oncology care, eliminates lost links in patient referral pathways, and ensures a high level of monitoring of the health status of patients with precancerous pathology of the cervix.

ABSTRACT: Cervical cancer remains a leading cause of cancer-related mortality in Sub-Saharan Africa, where it disproportionately affects women due to late-stage diagnoses. Despite the availability of preventive measures such as screening and HPV vaccination, uptake remains critically low. This systematic review and meta-analysis aimed to estimate the pooled prevalence and identify key predictors of cervical cancer screening uptake across Sub-Saharan Africa. A comprehensive search of databases including PubMed, Google Scholar, African Journal Online (AJOL) and ScienceDirect identified 27 studies involving a total of 357,586 women. Our results revealed that the overall prevalence of cervical cancer screening uptake was 21.2% (95% CI: 16.2%, 27.2%). Key predictors of uptake included education, healthcare access, awareness of cervical cancer, age, and integration with other health services like HIV care. This study underscores the urgent need for tailored interventions to address barriers such as lack of awareness, financial constraints, and cultural stigma. The findings provide crucial evidence to guide policy and public health strategies aimed at increasing screening rates and reducing the cervical cancer burden in the region.