Organization and evolution of organized cervical cytology screening in Thailand.

OBJECTIVE: To describe phase 1 of an organized cytology screening project initiated in Thailand by the Ministry of Public Health and the National Health Security Office. METHODS: Women aged 35-60 years were encouraged to undergo cervical screening in primary care units and hospitals through awareness programs. Papanicolaou smears were processed and reported at district or provincial cytology laboratories. Women with normal test results were advised to undergo repeat screening after 5 years, while those with precancerous and cancerous lesions were referred for colposcopy, biopsy, and treatment. Information on screening, referral, investigations, and therapy were logged in a computer database. RESULTS: Between 2005 and 2009, 69.2% of the 4030833 targeted women were screened. In all, 20991 women had inadequate smears; 27253 had low-grade squamous intraepithelial lesions; 15706 had high-grade squamous intraepithelial lesions; and 2920 had invasive cancers. Information on the management of precancerous lesions was available for only 17.4% of women referred for colposcopy. CONCLUSION: Although follow-up data on women with positive test results were inadequately documented, the present findings indicate that provision of cytology services through the existing healthcare system is feasible.

Quality of case ascertainment in cancer registries: a proposal for a virtual three-source capture-recapture technique.

BACKGROUND: The ability and behaviour of the capture-recapture method using a virtual three-source model for evaluation of the level of completeness of case ascertainment requires exploration. METHODS: Cancer cases obtained from 9 population-based cancer registries in Thailand during 2003 to 2007 were applied for capture-recapture using a model based on clinical, pathological and mortality data. These three virtual sources were derived from three actual items common to all cancer registries: the basis of diagnosis, ICD-O morphology code, and last known patient status. Poisson regression models were fit to the data to estimate parameters which were then transformed into demographic values. A linear model was used to determine the predictors and estimated percentage of completeness (EPC) in case ascertainment among the cancer registries. RESULTS: The EPC was greater than 97% in 5 and less than 90% in 4 registries. The worst had an EPC of 70%. The percentage death certificate only (%DCO) and the interaction between %DCO and morphological verification (MV) were significantly associated with EPC. Other factors intrinsic to registries also exerted influence on the EPC. CONCLUSIONS: In addition to other standard indicators to monitor completeness of cancer registries, the present virtual three-source capture-recapture model can be routinely used to estimate the level of completeness of case ascertainment in cancer registries.

Cancer epidemiology in mainland South-East Asia - past, present and future.

The countries of mainland South-East Asia, Myanmar, Thailand, Laos, Cambodia and Viet Nam, share a long history of interactions and many cultural similarities, as well as geographical contiguity. They therefore can be usefully examined as a group when considering measures for control of cancer and other non-communicable diseases. Liver cancer is consistently found at higher incidence than most other parts of Asia, with lung cancer as the other most important neoplasm in males. In females cervical and breast cancer about equally predominate, throughout. However, there are also major differences, particularly with regard to stomach and nasopharyngeal cancer, only found at relatively high incidence in Viet Nam. The present review was conducted to gather together registry data on cancer prevalence and epidemiological findings cited in PubMed in order to obtain as comprehensive picture as possible of the present status. It is hoped that future cooperation across the region will facilitate development of coordinated cancer control programs to reduce the burden.