National Cervical Cancer Screening in Thailand

Abstract

Background: Cervical cancer is an important public health problem in Thailand. It was the most common cancer in Thai women with the incidence rate of 23.4 per 100,000 women in 1990.

Objective: The aim of this study was to share the experiences and summary the outcome of cervical cancer screening program in Thailand.

Methods: The Ministry of Public Health in cooperation with the National Health Security Office, launched the National Cervical Cancer Screening Program, covering 76 provinces nationwide under Universal Coverage Scheme in 2005. The screening method are Pap smear and Visual Inspection with Acetic acid (VIA) for women aged 30-60 and 35-45 respectively with a 5-year screening interval. Detecting cervical pre-cancerous lesions will follow by day care treatment such as cryotherapy, Loop Electrosurgical Excision Procedure, etc. Results: The first phase (2005-2009), was carried out on 3,124,855 women, the coverage reached 77.5%. For the second phase (2010-2014), 7,637,226 women were screened, reaching 53.9% coverage of target women. However, we have few data of follow up examination after abnormal screening. Therefore, we conducted new system to get more follow up data in 2019. Under the coordination of many related partners, 10,762,081 women have been screened during 2005-2014. The incidence rate declined to 11.7 per 100,000 women which is ranked as the third most common in women in 2014.

Conclusion: This article briefly reviews the challenge of implementing an efficient cervical cancer screening in Thailand. In 2020, HPV testing has been introduced as a primary screening test for all Thai women attending public health sector instead of conventional Pap test.

Keywords: Cervical cancer; Population-based organized screening; Thailand.

Figure 1

Trends in the Age-Standardized Incidence Rates for Cervical Cancer in Thailand, 1990-2014. 1990 (Vatanasapt et al., 1993), 1993 (Deerasamee et al., 1999), 1996 (Sriplung et al., 2003), 1999-2008 (Khuhaprema et al., 2007; 2010; 2012; 2013), 2011 and 2014 (Imsamran et al., 2018)

Figure 2

Age-Standardized Incidence Rates of the Ten most Frequent Cancers in Thai Women, (A) 1990 (Vatanasapt et al., 1993) and (B) 2014 (Imsamran et al., 2018)