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  • Publication
    Cervical Cancer in Ukraine: The Continuum of Care and Implications for Action
    (World Bank, Washington, DC, 2019-01-11) World Bank
    Cervical cancer is an important disease in Ukraine: Among all cancers in females, it ranks 5th for incidence and 6th for mortality. While first year mortality shows some decline, progress in earlier detection has been very modest. This report presents key findings from an analysis of the continuum of cervical cancer care in Ukraine, where the World Bank implements a technical assistance program to support reforms and governance in the health sector. The analysis determined the breakpoints in the care cascade from screening to long-term monitoring of cases, and identified opportunities for action. The screening gaps were 47 percent (Lviv Region) and 38 percent (Poltava Region). Due to Ukraine's cervical cancer screening eligibility from 18 years of age, screening has a low yield, and this is further reduced by the short screening intervals with almost half of the women screening at least once every year, leading to efficiency concerns. Among the diagnosed cervical cancer cases, treatment completion and negative outcomes were not sufficiently documented. Understanding of diagnosis and treatment gaps helps pinpoint solutions ranging from simplified decision-making for cancer treatment, to improved pharmaceutical supplies and access to diagnostic equipment. The analysis highlights the need for age- and risk-appropriate screening invitations and recall systems to increase the efficiency and effectiveness of the cervical cancer program in Ukraine.