Skrínink pro prevenci karcinomu děložního hrdla v České republice

Screening for Prevention of Cervical Cancer in the Czech Republic

Cytological diagnosis of atypical cells of cervix uteri by the Papanicolaou method was introduced in the Czech Republic (CR) very early – in 1947. In 1966 the Czech National Health Law was passed that guaranteed women a yearly preventive examination by a gynaecologist which is covered by the compulsory health insurance. This preventive examination was and is considered as an equivalent of screening for cervical cancer. Notwithstanding high frequency of screening visits and the fact that all women are eligible, the incidence of CC has not changed in the last 34 years. The reasons for this include the coverage of Czech women, which is estimated to be low (35% at the most), and that none of the cytology laboratories are accredited for screening, there are no national registries for any aspect of screening and there are no mechanisms for evaluation of the screening process. As a result, it is obvious that the majority of opportunistic cervical screening activity that is undertaken is ineffective and the implementation of an organized and quality controlled screening programme, in compliance with the recommendations of many European Institutions, is urgently required to ensure that Czech women are properly protected against this disease and that scarce healthcare resources are used in the most costeffective manner. In the process of preparation of new screening programmes it is important to take into account the new achievements of science and new technologies, which are being gradually introduced into the clinical practice. Namely, the methods used for selection of women at risk that are based on the detection of nucleic acids of human papillomaviruses and vaccination against some types of these viruses, which are the etiological agents of precancerous lesions and cancer of cervix uteri. 

Key words:
cervix uteri, carcinomas, screening, HPV, vaccination.