Georgetown University Project: Cervical Cancer Prevention in Serbia
Authors: Justin Kasian, Radhika Kaul, Bailey Sutton, Dushyant Tyagi
After group of students from Georgetown University Master of Public Policy contacted us, we collaborated on a project, concerning development of a potential policy solution to cervical cancer screening and prevention in Serbia.
After a documentary One and a Half Women Each Day, on VICE and Balkan Insight interview, they targeted Marija Ratković as one of the foremost cervical cancer activists in the country. During the collaboration we shared information on cervical cancer incidence in Serbia and information on the effectiveness of the privately provided HPV vaccinations. We targeted the main considerations and milestones and come up with a public policy strategy blueprint.
The McCourt School of Public Policy at Georgetown University is a top-ranked public policy school located in the center of the policy world in Washington, D.C.
Cervical cancer is the 3rd most common cancer among women worldwide. It is the 2nd leading cause of cancer deaths in women aged 15 to 44 years in Serbia. The primary cause is infection with Human Papilloma Viruses (HPV), which are sexually transmitted. It has been shown that reducing HPV infections will dramatically reduce cases of cervical cancer. Therefore, the HPV vaccine is the most sought after treatment in many countries to decrease the incidence rate. In Serbia, existing programs have focused on secondary intervention methods – identifying those with cervical cancer and then treating it. The result of this is low levels of understanding of cervical cancer among the general population and no national vaccination program.
Considerations Additional considerations are as follows:
- Current vaccine prices are prohibitively expensive, so reducing costs will need to be a priority.
- Immunity requires multiple vaccines in relatively quick succession, so girls who drop out of school or who are absent may miss a dosage.
- Certain minority populations, such as the Roma people, may not attend traditional schools and will be excluded from the program.
- Rollout dates and information campaigns must be scheduled around school calendars and national holidays
Antic, L.G., Djikanovic, B. S., Antic, D. Z., Aleksopulos, H. G., & Trajkovic, G. Z. (2014). Differencies in the level of knowledge on cervical cancer among health care students, midwives and patients in Serbia. Asian Pacific Journal of Cancer Prevention, 15, 3011- 3015. link
● Statistics on the knowledge of cervical cancer in the general population of women, midwives, and medical students in Serbia. Bruni L., Albero G., Serrano B., Mena M., Gómez D., Muñoz J., Bosch F.X., & de Sanjosé S. (2018). Human papillomavirus and related diseases in Serbia [PDF file]. Information Centre on HPV and Cancer (HPV Information Centre). link (Summary report).
● Statistics on incidence and mortality rates of cervical cancer in Serbia. Mesher, D., Panwar, K., Thomas, S. L., Edmundson, C., Choi, Y. H., Beddows, S., & Soldan, K. (2018). The impact of the national HPV vaccination program in England using the bivalent HPV vaccine: Surveillance of type-specific HPV in young females, 2010–2016. The Journal of infectious diseases, 218(6), 911-921. link
● Results for national HPV vaccination drive in UK among young girls and its effectiveness. Nikolic, Z., Matejic, B., Kesic, V., Marinkovic, J.E., & Jovic Vranes, A. (2015). Factors influencing the recommendation of the human papillomavirus vaccine by Serbian pediatricians. Journal of Pediatric and Adolescent Gynecology, 28(1), 12-18. link
● Information on why the vaccine is not recommended, specifically high costs and low levels of parental knowledge.