Alban Ylli1, Kozeta Filipi1, Lila Shundi1, Albana Fico1, Bajram Dedja1, Mirela Risto2,
Anila Xhani2
1 Institute of Public Health, Tirana, Albania;
2 University Hospital Center “Mother Teresa”, Tirana, Albania;
3 Faculty of Medicine, University of Medicine, Tirana, Albania.
Aim: In 2019 Albania has started a national screening program which uses as primary screening examination the high risk Human Papilloma Virus testing. It targets women 40-50 years old with the goal is to provide within five years, all women in this age group, high risk HPV screening tests, as part of the routine examinations done at primary health care centers.
Methods: Each health center physician refers women who have come out positive in primary screening test, to perform a diagnostic colposcopy to a qualified gynecologist and, when necessary, cytology or biopsy. The program allows for the diagnosis of pre-cancerous stages, their treatment and prevention of cervical cancer. The evaluation study that took place during October-November 2019 aimed to identify the performance of the program, barriers and satisfaction of women
Results: The program has been used comparatively more by women living in rural areas (58%). The majority of women found the vaginal sampling procedure very simple (60%) and not at all painful (72%). 96% of women received their results within the program promise of two months. At the time of the survey, around 90% of HPV-positive women either had gone for follow up visit or were planning to go as soon as possible. More than one in three women who have performed colposcopy, have chosen private healthcare for that. Additionally, 8% have gone abroad for the follow up examination. Women with university education were more inclined to go for the follow up visit to a private facility and especially abroad. 87% of positive women reported substantial worries about the positive result. Around 9 in 10 of women rated the overall service at PHC, as well as at specialized care ‘good’ or ‘very good’.
Conclusion: Results from the first evaluation show good acceptance from women of the new program. There are still 10% of women who although resulted positive in screening test are reluctant to go for follow up examination. Additionally, a large proportion of women resulting positive in screening test chose private clinics for follow up examination. Both issues should be addressed by health system.
Keywords: cervical cancer, HPV, primary health care.