Analysis of screening history of cervical cancer cases in Latvia

Background:
Latvia has one of the highest cervical cancer rates in Europe. An organized population-based screening program was implemented in 2009, and in 2022, primary HPV screening was introduced.
Aims:
This study aims to analyze the screening history of women diagnosed with cervical cancer in 2022.
Methods:
Data from the Register of Patients Suffering from Certain Diseases was used in an observational study of women diagnosed with cervical cancer in 2022. The analysis included screening test history and HPV vaccination status from 2014 to 2022 from the National Health Service system for publicly funded outpatient services.
Results:
In 2022, 150 women with a diagnosis of cervical cancer were registered. The average age was 61.5 years. In the period, between 2014 and 2022, none had received the HPV vaccine. 117(78%) women were invited for screening at least once. 56(47.9%) women underwent at least one screening test and only 15(12.8%) women did all screening tests. 70%(n=14) of women with stage I cervical cancer, 46.7%(n=7) with stage II, 63.6%(n=21) with stage III, and 23.5%(n=4) of women with stage IV cervical cancer underwent screening. Between 2014 and 2022, 2 screening cytological tests were unsatisfactory, 37 had no intraepithelial lesion found, 5 had ASC-US, 3 had LSIL, 15 had HSIL, 2 had AGUS, and 10 showed signs of malignancy in cytology. 18(32%) of women underwent a colposcopy.
Conclusions:
There could be several reasons for the high incidence of cervical cancer in Latvia. Possible factors include low participation in screening, insufficient quality of screening tests, and non-adherence to existing guidelines.