Nationwide screening program for breast and cervical cancers in Hungary: special challenges, outcomes, and the role of the primary care provider.
BACKGROUND
Breast and cervical cancers are both common malignancies in Hungarian women. The aim of this study was to evaluate the impact of nationwide screening programs on the incidence and mortality of breast and cervical cancers and to assess the role of primary care providers in this context.


METHODS
Published records from 2000-2011 on breast and cervical cancer screening activities in Hungary were reviewed. Previously unpublished data from the Hungarian National Cancer Registry were also included in this review. Hungarian outcomes were compared to international results.


RESULTS
A nationwide screening program for breast cancer was established in Hungary in 2001. A similar program for cervical cancer was subsequently initiated in 2003. As of 2009, 50% of the population at risk took advantage of breast cancer screening, while the exact participation rate for cervical cancer screening could not be established due to deficiencies of reporting by private gynecologists. The Health Visitors Cervical Screening Program, a new initiative within the context of the nationwide cervical screening program, based on involvement of local primary care providers, had encouraging results which substantially raised participation rates. However, deficiencies were identified regarding flow of information between service providers, patients, and family physicians. There was a slight reduction in the incidence of breast cancer and a more pronounced reduction in the incidence of cervical cancer, as well as a reduction in mortality for both breast and cervical cancers associated with these screening initiatives.


CONCLUSIONS
The inclusion of primary care providers may benefit nationwide screening programs by raising participation rates in the target population.
Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary. kolozsvari.laszlo@sph.unideb.hu
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Kolozsvári
2nd Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.
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Langmár
Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
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Rurik
D001943:Breast Neoplasms / Q000453:epidemiology* / Q000401:mortality; D055088:Early Detection of Cancer; D005260:Female; D006282:Health Personnel; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D008403:Mass Screening / Q000379:methods*; D011320:Primary Health Care; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000401:mortality