think about yourself – only the early discovered breast cancer may be medically treated with...
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“THINK ABOUT YOURSELF – Only The Early Discovered Breast Cancer May Be Medically Treated With Success”
Is the project co-financed by the European Union
PROJECT “THINK ABOUT YOURSELF – ONLY THE PROJECT “THINK ABOUT YOURSELF – ONLY THE EARLY DISCOVERED BREAST CANCER MAY BE EARLY DISCOVERED BREAST CANCER MAY BE MEDICALLY TREATED WITH SUCCESS”MEDICALLY TREATED WITH SUCCESS”
Association “Education against breast cancer” from Zagreb County ran this project from 2007/2009. Basic information about the Association:- Founded on May 22nd, 2001- Primary activity: education of women of all ages in correct and regular self breast examination and raising consciousness about personal health with the primary goal: health through prevention
Projekt sufinancira Europska unijaProject is co-financed by the European Union
Project “THINK ABOUT YOURSELF In 2007 the Association won CARDS 2004 contest with the
project “THINK ABOUT YOURSELF” We are the only association from Zagreb County with a
project financed by this contest Zagreb County recognized this project and got involved as
the partner Total project budget is 219,379.80 EUR:
81% financed by CARDS 2004 19% financed by Zagreb County (160,088.68 HRK)
and the Association (152,187.48 HRK) The Association geathered funds through humanitary
actions
charity concerts
and donations
Projekt sufinancira Europska unijaProject is co-financed by the European Union
Project goals
Expanding the National program of breast cancer
prevention in the Republic of Croatia (age 50-69 years)
Expanding the network of trained personnel for
education of early breast cancer detection
Promotion of self breast examination for breast cancer
prevention through organized workshops, media
coverage and public forums
Projekt sufinancira Europska unijaProject is co-financed by the European Union
Target groups and expected results
Women 18 - 49 years – education in correct self breast examination Women 30 - 39 years – free breast ultrasound Women 40 - 49 years – free mammography 13 trainers for education of correct self breast examination
AgeTarget group
(total number)Education Ultrasound Mammography
18-29 1000
30-39 1000
40-49 4500
50-65 0
6500 6500 1000 4500
Type of serviceProject plan
Projekt sufinancira Europska unijaProject is co-financed by the European Union
Results of the Project(Jun 27th, 2007 – Jun 16th, 2009)
AgeTarget group
(total number)Education Ultrasound Mammography
- 13 trainers 13 100%
18-29 1000 1003 100%
30-39 1000 1000 100%
40-49 4500 4357 97%
50-65 0 0
6500 6500 1000 4500 6360 98%
Achieved result
Type of serviceProject plan Results of the project "Think
About Yourself"
“THINK ABOUT YOURSELF – Only The Early Discovered Breast Cancer May Be Medically Treated With Success”
Is the project co-financed by the European Union
Results of ultrasound and Results of ultrasound and mammography mammography
Results of assessments and clinical findings:- 13 trained educators- 6500 women educated in breast self examination - 931 breast ultrasounds (30-39 years)- 4398 mammographies (40-49 years)
Projekt sufinancira Europska unijaProject is co-financed by the European Union
Results of ultrasound examinations (30 – 39 years)
NORMAL FINDINGS 358 FIBROUS CHANGES-mastopathy 425 SEVERE FIBROCYSTIC DYSPLASIA 91 BENIGN-LOOKING NODES 57 DEFINITE SIGNS OF MALIGNANCY 0 TOTAL 931
Projekt sufinancira Europska unijaProject is co-financed by the European Union
Results of mammography findings (40 - 49 years)
LEGEND: R1 – NORMAL FINDINGS R2 – BENIGN
CHARACTERISTICS R3 – INDETERMINATE
FINDINGS R4 – SUSPICIOUS FINDINGS R5 – MALIGNANT CHANGES
8 WOMEN OPERATED !
Projekt sufinancira Europska unijaProject is co-financed by the European Union
Recommendations according to mammography results (40 – 49 years)
LEGEND: 1 – CONTROL EXAM IN 2
YEARS 2 – REFERRED TO FAMILY
PHYSICIAN + ULTRASOUND 3 – REFERRED TO THE
BREAST DISEASE CENTER
(ULTRASOUND, ADDITIONAL
MAMMOGRAPHIES,
CYTOLOGY)
Total: 3,985
recommendations
Projekt sufinancira Europska unijaProject is co-financed by the European Union
Association “Edication against breast cancer” from Zagreb County
In parallel to the project THINK ABOUT YOURSELF, the Association coducted education, ultrasound and mammography examinations also for the:
age group 50-60 years, since 2003 (“County program”) age group 50-69 years, since 2007 (“National program”)
Statistics, findings and medical recommendations for all projects were analyzed separately
Projekt sufinancira Europska unijaProject is co-financed by the European Union
Contacts:
1) Gorana Rabatić, Zagreb CountyPhone: +385 1 6009 475
Fax: +385 1 6009 488E-mail: [email protected]
2) Joško Zekan, MD, MScPhone: +385 91 6150 555E-mail: [email protected]: www.womens-health-initiative.com
3) Mario Kopljar, MD, PhDPhone: +385 91 582 7446E-mail: [email protected]
Reproductive health care Croatian perspective
Mario Kopljar, Joško Zekan
Public health impact of STD
• Sexually transmitted diseases have a sigificant influence on the pupulation reproductive health
• Infertility 12%• Healthcare burden• Reductio of working abillities (hepatitis B, sick
leave)
Incidence of STD in Croatiaper 100000
• Chlamydia 19.9 -12.9
• Gonococcal infections 0.6 - 0.4
• Hepatitis B 4.4 - 3.0
• HIV 0.7 - 1.5
• HPV 22.3 - 38.4
• Reduction of STD incidence
• HIV incidence under control – education, – promotion of anonymous testing, – legal purchase of sterile needles in pharmacies
• Growing problem is HPV
• HPV infection represents a major health problem because of its relation to cervical cancer
• HPV Summit 1999: there is no cervical cancer without HPV infection
• Cervical cancer is a preventable disease
Cervical cancer – incidence
• Latin America 55-72 / 100 000 women
• Croatia 16.8 / 100 000 women
• Israel, Finland 3-4 / 100 000 women
• SMOKING – LUNG CANCER:
ODD RATIO =17
• HPV INFECTION – CERVICAL CANCER:
ODD RATIO =150-250
High risk population• Sexarche before the age of 17• Promisquity• Early pregnancy• High-risk HPV infection• Low socioeconomical status• Immunodeficient conditions• Smoking• Nutritional deficit• Oral contraception• High-risk partners• Non-existance of national screening programme
Situation in Croatia
597 gyneacologists 142 pathologists 115 cytologists 112 cytoscreeners Opportunistic screening (OR
0.57): ~ 400 000 PAP-smears/year
Organized screening (OR 0.25): 1 198 299 women (25-65 years)
• Croatia has enough resources for opportunistic screening (patients seeking medical attention, 400 000 PAP-smear/year)
• The goal of Womens Health Initiative: doctors activelly addressing people (organized screening) with anticipated reduction in STD incidence by 50%
• Target group for prevention – adolescents• Adolescent behavior and knowledge
- More than 50% of adolescents is under influence of alcohol or drugs before intercourse
- Only 6% tested for STD- Insufficient knowledge regarding contraception
and prevention of STD- However … over 60% seek relevant education
Cervical cancer prevention modalities
• Education– Insitutional (schools)– Extra-institutional
• Public schools
• Courses
• Media
• Screening• Vaccination
Figure reproduced from: Quinn M, Babb P, Jones J, Allen E. Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics. BMJ 1999; 318: 904. Reproduced with permission from the BMJ Publishing Group.
Impact of vaccination strategies diagnosed HPV 16/18-related cervical cancer incidence, females (12+y), lifelong duration
0
1
2
3
4
5
0 10 20 30 40 50 60 70 80 90 100
Time in Years
Inci
denc
e pe
r 100
,000
.
No Vaccination12-yo females12-yo females+females catch up12-yo females&males12-yo females&males+females catch up12-yo females&males+females and males catch up
Reproductive health careResults of campagne:
•⇓ Pelvic Inflammatory Disease
•⇓Ectopic pregnancy
•⇓ Sterility
•⇓ Impact on state budget for health
• Womens Health Initiative continues Womens Health Initiative continues to promote reproductive health to promote reproductive health through organizing european through organizing european conferences conferences
• Croatia accepted modern guidelines for Croatia accepted modern guidelines for protection of reproductive health and protection of reproductive health and significantly improved reproductive health significantly improved reproductive health