Sõeluuringutele kutsutavate vanusepiiri tõstmine Rinnavähi sõeluuringud Aastal 2020 oli surmapõhjustajatest teisel kohal pahaloomulised kasvajad (N=3802) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"E5S8a1xw","properties":{"formattedCitation":"(1)","plainCitation":"(1)","noteIndex":0},"citationItems":[{"id":858,"uris":["http://zotero.org/users/7083350/items/8TT78NSG"],"itemData":{"id":858,"type":"webpage","title":"Statistika: ligi pooled surmadest olid 2020. aastal tingitud vereringeelundite haigustest | Tervise Arengu Instituut","URL":"https://www.tai.ee/et/uudised/statistika-ligi-pooled-surmadest-olid-2020-aastal-tingitud-vereringeelundite-haigustest","accessed":{"date-parts":[["2022",7,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (1) . Nendest 6% moodustas rinnavähk ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"FZ9HLJBS","properties":{"formattedCitation":"(1)","plainCitation":"(1)","noteIndex":0},"citationItems":[{"id":858,"uris":["http://zotero.org/users/7083350/items/8TT78NSG"],"itemData":{"id":858,"type":"webpage","title":"Statistika: ligi pooled surmadest olid 2020. aastal tingitud vereringeelundite haigustest | Tervise Arengu Instituut","URL":"https://www.tai.ee/et/uudised/statistika-ligi-pooled-surmadest-olid-2020-aastal-tingitud-vereringeelundite-haigustest","accessed":{"date-parts":[["2022",7,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (1) . Rinnavähk on kõige sagedamini esinev pahaloomuline kasvaja naiste seas. Seetõttu korraldatakse Eestis rinnavähi sõeluuringuid, kus kutsutakse sõeluuringule 50 – 69 aastaseid naisi iga kahe aasta tagant ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"IfGXhLRm","properties":{"formattedCitation":"(2)","plainCitation":"(2)","noteIndex":0},"citationItems":[{"id":856,"uris":["http://zotero.org/users/7083350/items/7YS23Y65"],"itemData":{"id":856,"type":"post-weblog","abstract":"2022. aastal kutsutakse rinnavähi sõeluuringule naised sünniaastaga 1954, 1956, 1958, 1960, 1962, 1964, 1966, 1968, 1970, 1972.","language":"en","title":"RINNAVÄHI SÕELUURING - Soeluuring.ee","URL":"https://soeluuring.ee/rinnavahk/","accessed":{"date-parts":[["2022",7,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (2) . Mammograafias on võimalik naistel käia ka ilma kutse ta , pöördudes enda pere-või naistearsti poole , kes suunab nad saatekirjaga uuringule . T asudes 5 eurot visiiditasu on v õimalik minna ka iseseisvalt rinnakabinetti . ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"zNBgg3Z4","properties":{"formattedCitation":"(2)","plainCitation":"(2)","noteIndex":0},"citationItems":[{"id":856,"uris":["http://zotero.org/users/7083350/items/7YS23Y65"],"itemData":{"id":856,"type":"post-weblog","abstract":"2022. aastal kutsutakse rinnavähi sõeluuringule naised sünniaastaga 1954, 1956, 1958, 1960, 1962, 1964, 1966, 1968, 1970, 1972.","language":"en","title":"RINNAVÄHI SÕELUURING - Soeluuring.ee","URL":"https://soeluuring.ee/rinnavahk/","accessed":{"date-parts":[["2022",7,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (2) Seega hetkel jäävad uuringu kutseta vanemad naised ( ≥ 70 eluaastat) . Samas a astal 2019 haigestus vanuses 60 – 64 rinnavähki 169 naist 100 000 elaniku kohta, kuid vanusrühmas 70 – 74 haigestus rinnavähki 231 naist 100 000 elaniku kohta (Joonis 1) . ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"GvxQk9dl","properties":{"formattedCitation":"(3)","plainCitation":"(3)","noteIndex":0},"citationItems":[{"id":861,"uris":["http://zotero.org/users/7083350/items/DZIC8XEV"],"itemData":{"id":861,"type":"webpage","title":"PK30: Pahaloomuliste kasvajate haigestumuse vanuskordajad 100 000 elaniku kohta paikme ja soo järgi. PxWeb","URL":"https://statistika.tai.ee/pxweb/et/Andmebaas/Andmebaas__02Haigestumus__04PahaloomulisedKasvajad/PK30.px/sortedtable/tableViewSorted/","accessed":{"date-parts":[["2022",7,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (3) Joonis 1 . Rinnavähi haigestumuse vanuskordajad 100 000 elaniku kohta vanuserühmades 50 kuni 74 (3). Üldiselt on Eestis rinnavähi sõeluuringutega hõlmatus umbes 55% ja üle erinevate vanusgruppide jääb see vahemikku 52 – 58% ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"RxyMsG28","properties":{"formattedCitation":"(4)","plainCitation":"(4)","noteIndex":0},"citationItems":[{"id":863,"uris":["http://zotero.org/users/7083350/items/HRFJ7Z39"],"itemData":{"id":863,"type":"webpage","title":"VSR02: Rinnavähi sõeluuringu sihtrühma hõlmatus mammograafilise uuringuga vanuse järgi. PxWeb","URL":"https://statistika.tai.ee/pxweb/et/Andmebaas/Andmebaas__02Haigestumus__07Soeluuringud/VSR02.px/table/tableViewLayout2/","accessed":{"date-parts":[["2022",7,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (4) . Rinnavähi sõeluuringud ülejäänud Euroopas Võrreldes ülejäänud Euroopaga jääb Eesti enda rinnavähi sõeluuringute hõlmatuses umbes kes kele (Joonis 2) . Aastal 2017 olid madala imad hõlmatuse tasemeid (< 50%) rii kidel nagu Rumeenia, Bulgaaria ja Slovakkia. Samas üle 75% hõlmatusega olid Taani, Soome, Holland ja Suurbritannia . ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"iO7cVb3A","properties":{"formattedCitation":"(5)","plainCitation":"(5)","noteIndex":0},"citationItems":[{"id":865,"uris":["http://zotero.org/users/7083350/items/FMEGIBMK"],"itemData":{"id":865,"type":"webpage","abstract":"In 2017, the proportion of women aged 50-69 years who had been screened for breast cancer (using a mammography) within the previous two years differed greatly among Member States. Based on screening programmes, eight Member States had breast cancer screening rates below 50%, with the lowest rates in Romania (0.2% of women aged 50-69 – 2015 data), Bulgaria (20.6%) and Slovakia (30.7%). By contrast, there were four Member States that reported breast cancer screening rates of 75% or above: Denmark (82.1% in 2016), Finland (81.9%), the Netherlands (78.2% in 2015) and the United Kingdom (75.1%). The source dataset can be found here. For more information, see the Statistics Explained article Healthcare activities statistics - preventive services. To contact us, please visit our User Support page. For press queries, please contact our Media Support.","language":"en-GB","title":"Breast cancer screening differs among Member States","URL":"https://ec.europa.eu/eurostat/web/products-eurostat-news/-/DDN-20200109-1","accessed":{"date-parts":[["2022",7,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (5) Joonis SEQ Figure \* ARABIC 2 . Rinnavähi sõeluuringutega hõlmatuse osakaalud Euroopas aastal 2017 (5) . Sarnaselt Eestile kutsu s aasta 2014 seisuga 50 – 69 aastaseid naisi sõeluuringule 13 Euroopa Liidu liikmesriiki, mis moodustab 46% liikmesriikidest (13/28). Üle 70-aastaseid kutsutakse sõeluuringule Prantsusmaal, Itaalias, Hollandis ja Rootsis . ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Lfs3K738","properties":{"formattedCitation":"(6)","plainCitation":"(6)","noteIndex":0},"citationItems":[{"id":867,"uris":["http://zotero.org/users/7083350/items/IDCH9JEN"],"itemData":{"id":867,"type":"article-journal","abstract":"Breast cancer, a major cause of female morbidity and mortality, is a global health problem; 2008 data show an incidence of ~450,000 new cases and 140,000 deaths (mean incidence rate 70.7 and mortality rate 16.7, world age-standardized rate per 100,000 women) in European Union Member States. Incidence rates in Western Europe are among the highest in the world. We review the situation of BC screening programmes in European Union. Up to date information on active BC screening programmes was obtained by reviewing the literature and searching national health ministries and cancer service websites. Although BC screening programmes are in place in nearly all European Union countries there are still considerable differences in target population coverage and age and in the techniques deployed. Screening is a mainstay of early BC detection whose main weakness is the rate of participation of the target population. National policies and healthcare planning should aim at maximizing participation in controlled organized screening programmes by identifying and lowering any barriers to adhesion, also with a view to reducing healthcare costs.","container-title":"International Journal of Oncology","DOI":"10.3892/ijo.2014.2632","ISSN":"1019-6439","issue":"5","note":"publisher: Spandidos Publications","page":"1785-1792","source":"www.spandidos-publications.com","title":"Breast cancer in European Union: An update of screening programmes as of March 2014 (Review)","title-short":"Breast cancer in European Union","volume":"45","author":[{"family":"Altobelli","given":"E."},{"family":"Lattanzi","given":"A."}],"issued":{"date-parts":[["2014",11,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (6) Miks tõsta rinnavähi sõeluuringute le kutsutavate vanusepiiri? Esiteks tooks välja, et Euroopa Komisjon soovitus on pakkuda kahe aastaste vahedega rinnavähi sõeluuringut naistele vanuses 50 – 69, kuid ka kolme aastaste vahedega naistele vanuses 70 – 74 aastat ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"JbcwwQQd","properties":{"formattedCitation":"(7)","plainCitation":"(7)","noteIndex":0},"citationItems":[{"id":870,"uris":["http://zotero.org/users/7083350/items/4M5ECE7V"],"itemData":{"id":870,"type":"webpage","language":"en","title":"European Commission Initiative on Breast and Colorectal Cancer","URL":"https://healthcare-quality.jrc.ec.europa.eu","accessed":{"date-parts":[["2022",7,28]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (7) . Euroopa Komisjon on enda süstemaatilises ülevaates toonud välja, et mammograafia pakkumine 70 kuni 74 aastastele naistele vähendab rinnavähis t põhjustatud suremust 690 juhu võrra 100 000 elaniku kohta. Samuti vähendab see II astme rinnavähi riski 385 juhu võrra ja vähendab suurenenud kasvajate ( ≥ 50 mm) hulka 63 juhu võrra 100 000 naise kohta. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"uiQR916e","properties":{"formattedCitation":"(8)","plainCitation":"(8)","noteIndex":0},"citationItems":[{"id":855,"uris":["http://zotero.org/users/7083350/items/7IKPKPME"],"itemData":{"id":855,"type":"document","title":"ECIBC_GLs_EtD_screening_70-74.pdf","URL":"https://healthcare-quality.jrc.ec.europa.eu/sites/default/files/Guidelines/EtDs/ECIBC_GLs_EtD_screening_70-74.pdf","accessed":{"date-parts":[["2022",7,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (8) Lisaks on toodu ka välja, et vanuse suurendami sel oleks kulutõhus us samal tasemel kui praegune strateegia. Erinevate rinnavähi sõeluuringu strateegiate hindamise l on toodud esile, et kahe aastase vahega 50 – 69 või 50 – 74 aastaste sõelumine on kõige efektiivsem ad ( ehk ei olnud strateegiaid, mis päästaks rohkem QALY’sid sama hinna eest) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"AqnqKeRf","properties":{"formattedCitation":"(9)","plainCitation":"(9)","noteIndex":0},"citationItems":[{"id":845,"uris":["http://zotero.org/users/7083350/items/XD3KEPPH"],"itemData":{"id":845,"type":"article-journal","container-title":"Journal of Clinical Oncology","DOI":"10.1200/JCO.19.01525","ISSN":"0732-183X","issue":"4","journalAbbreviation":"J Clin Oncol","note":"PMID: 31804858\nPMCID: PMC6994253","page":"332-350","source":"PubMed Central","title":"Systematic Review of the Cost Effectiveness of Breast Cancer Prevention, Screening, and Treatment Interventions","volume":"38","author":[{"family":"Jayasekera","given":"Jinani"},{"family":"Mandelblatt","given":"Jeanne S."}],"issued":{"date-parts":[["2020",2,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (9) . QALY ( Quality-adjusted life year ) abil mõõdetakse kulu kvaliteetse eluaasta kohta. Emakakaelavähi sõeluuring ud Emakakaelavähi sõeluuringule kutsutakse 30–65 aastaseid naisi iga viie aasta tagant. Enne aastat 2021 kutsuti emakakaelavähi sõeluuringule naisi vanuses 30 –59 aastat. Vähi peamiseks tekitajaks on inimese papilloomviiruse (HPV, ingl Human Papilloma Virus ) tüved, mis levivad sugulisel teel. Nakkusallikaks on nimetatud viirusega nakatanud teine inimene. Nakatumisel võivad aja möödudes tekkida muutused, mis võivad edasi areneda emakakaelavähiks. HPV vastu on võimalik ka vaktsineerida . ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"TXejCh6Y","properties":{"formattedCitation":"(10)","plainCitation":"(10)","noteIndex":0},"citationItems":[{"id":933,"uris":["http://zotero.org/users/7083350/items/MHWH8TID"],"itemData":{"id":933,"type":"webpage","abstract":"Vähi sõeluuringu kontaktid","container-title":"Haigekassa","language":"et","title":"Vähi sõeluuringud naistele","URL":"https://www.haigekassa.ee/soeluuring","accessed":{"date-parts":[["2022",9,16]]},"issued":{"date-parts":[["2017",9,28]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (10) Tabel 1. Munasarjavähi sõeluuringu vanusvahemikud riigiti ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"9iY7O5Ig","properties":{"formattedCitation":"(10,11)","plainCitation":"(10,11)","noteIndex":0},"citationItems":[{"id":933,"uris":["http://zotero.org/users/7083350/items/MHWH8TID"],"itemData":{"id":933,"type":"webpage","abstract":"Vähi sõeluuringu kontaktid","container-title":"Haigekassa","language":"et","title":"Vähi sõeluuringud naistele","URL":"https://www.haigekassa.ee/soeluuring","accessed":{"date-parts":[["2022",9,16]]},"issued":{"date-parts":[["2017",9,28]]}}},{"id":935,"uris":["http://zotero.org/users/7083350/items/A9VPT2I6"],"itemData":{"id":935,"type":"article-journal","abstract":"Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.","container-title":"Viruses","DOI":"10.3390/v10120729","ISSN":"1999-4915","issue":"12","language":"en","license":"http://creativecommons.org/licenses/by/3.0/","note":"number: 12\npublisher: Multidisciplinary Digital Publishing Institute","page":"729","source":"www.mdpi.com","title":"Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing","title-short":"Cervical Cancer Screening Programs in Europe","volume":"10","author":[{"family":"Chrysostomou","given":"Andreas C."},{"family":"Stylianou","given":"Dora C."},{"family":"Constantinidou","given":"Anastasia"},{"family":"Kostrikis","given":"Leondios G."}],"issued":{"date-parts":[["2018",12]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (10,11) . Riik Emakakaelavähi sõeluuringu kutse vanusvahemik Eesti 30 –65 Läti 25 –69 Leedu 25 –59 Soome (25) 30 – 65 Rootsi 21 –65 Norra 25 –69 Suur Britanni a 25 –64 Saksamaa 20 –60 Prantsusmaa 25 –65 Ameerika Vähi Assosatsioon soovitab, et 65+ vanustel naistel võib lõpetada sõeluuringud kui eelnevalt on olnud kõik testid negatiivsed ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"89Nt0MwN","properties":{"formattedCitation":"(12)","plainCitation":"(12)","noteIndex":0},"citationItems":[{"id":941,"uris":["http://zotero.org/users/7083350/items/Z9TS4WAP"],"itemData":{"id":941,"type":"article-journal","abstract":"The American Cancer Society (ACS) recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary human papillomavirus (HPV) testing every 5 years through age 65 years (preferred); if primary HPV testing is not available, then individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years (acceptable) (strong recommendation). The ACS recommends that individuals aged >65 years who have no history of cervical intraepithelial neoplasia grade 2 or more severe disease within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years, discontinue all cervical cancer screening (qualified recommendation). These new screening recommendations differ in 4 important respects compared with the 2012 recommendations: 1) The preferred screening strategy is primary HPV testing every 5 years, with cotesting and cytology alone acceptable where access to US Food and Drug Administration-approved primary HPV testing is not yet available; 2) the recommended age to start screening is 25 years rather than 21 years; 3) primary HPV testing, as well as cotesting or cytology alone when primary testing is not available, is recommended starting at age 25 years rather than age 30 years; and 4) the guideline is transitional, ie, options for screening with cotesting or cytology alone are provided but should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers. Evidence related to other relevant issues was reviewed, and no changes were made to recommendations for screening intervals, age or criteria for screening cessation, screening based on vaccination status, or screening after hysterectomy. Follow-up for individuals who screen positive for HPV and/or cytology should be in accordance with the 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.","container-title":"CA: A Cancer Journal for Clinicians","DOI":"10.3322/caac.21628","ISSN":"1542-4863","issue":"5","language":"en","note":"_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21628","page":"321-346","source":"Wiley Online Library","title":"Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society","title-short":"Cervical cancer screening for individuals at average risk","volume":"70","author":[{"family":"Fontham","given":"Elizabeth T. H."},{"family":"Wolf","given":"Andrew M. D."},{"family":"Church","given":"Timothy R."},{"family":"Etzioni","given":"Ruth"},{"family":"Flowers","given":"Christopher R."},{"family":"Herzig","given":"Abbe"},{"family":"Guerra","given":"Carmen E."},{"family":"Oeffinger","given":"Kevin C."},{"family":"Shih","given":"Ya-Chen Tina"},{"family":"Walter","given":"Louise C."},{"family":"Kim","given":"Jane J."},{"family":"Andrews","given":"Kimberly S."},{"family":"DeSantis","given":"Carol E."},{"family":"Fedewa","given":"Stacey A."},{"family":"Manassaram-Baptiste","given":"Deana"},{"family":"Saslow","given":"Debbie"},{"family":"Wender","given":"Richard C."},{"family":"Smith","given":"Robert A."}],"issued":{"date-parts":[["2020"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (12) . Ne ed nais ed , kes on üle 65 aasta vanad ja kellel puuduvad eelnevad uuringud peak s id jätkama sõeluuringutega ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"sOmqawqv","properties":{"formattedCitation":"(12)","plainCitation":"(12)","noteIndex":0},"citationItems":[{"id":941,"uris":["http://zotero.org/users/7083350/items/Z9TS4WAP"],"itemData":{"id":941,"type":"article-journal","abstract":"The American Cancer Society (ACS) recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary human papillomavirus (HPV) testing every 5 years through age 65 years (preferred); if primary HPV testing is not available, then individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years (acceptable) (strong recommendation). The ACS recommends that individuals aged >65 years who have no history of cervical intraepithelial neoplasia grade 2 or more severe disease within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years, discontinue all cervical cancer screening (qualified recommendation). These new screening recommendations differ in 4 important respects compared with the 2012 recommendations: 1) The preferred screening strategy is primary HPV testing every 5 years, with cotesting and cytology alone acceptable where access to US Food and Drug Administration-approved primary HPV testing is not yet available; 2) the recommended age to start screening is 25 years rather than 21 years; 3) primary HPV testing, as well as cotesting or cytology alone when primary testing is not available, is recommended starting at age 25 years rather than age 30 years; and 4) the guideline is transitional, ie, options for screening with cotesting or cytology alone are provided but should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers. Evidence related to other relevant issues was reviewed, and no changes were made to recommendations for screening intervals, age or criteria for screening cessation, screening based on vaccination status, or screening after hysterectomy. Follow-up for individuals who screen positive for HPV and/or cytology should be in accordance with the 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.","container-title":"CA: A Cancer Journal for Clinicians","DOI":"10.3322/caac.21628","ISSN":"1542-4863","issue":"5","language":"en","note":"_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21628","page":"321-346","source":"Wiley Online Library","title":"Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society","title-short":"Cervical cancer screening for individuals at average risk","volume":"70","author":[{"family":"Fontham","given":"Elizabeth T. H."},{"family":"Wolf","given":"Andrew M. D."},{"family":"Church","given":"Timothy R."},{"family":"Etzioni","given":"Ruth"},{"family":"Flowers","given":"Christopher R."},{"family":"Herzig","given":"Abbe"},{"family":"Guerra","given":"Carmen E."},{"family":"Oeffinger","given":"Kevin C."},{"family":"Shih","given":"Ya-Chen Tina"},{"family":"Walter","given":"Louise C."},{"family":"Kim","given":"Jane J."},{"family":"Andrews","given":"Kimberly S."},{"family":"DeSantis","given":"Carol E."},{"family":"Fedewa","given":"Stacey A."},{"family":"Manassaram-Baptiste","given":"Deana"},{"family":"Saslow","given":"Debbie"},{"family":"Wender","given":"Richard C."},{"family":"Smith","given":"Robert A."}],"issued":{"date-parts":[["2020"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (12) . Rootslased soovitavad, et üle 65 aastastel võib sõeluuringud lõpetada kui eelneva 10 aasta jooksul on olnud kõik testid normaalsed ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ZQqWliyO","properties":{"formattedCitation":"(13)","plainCitation":"(13)","noteIndex":0},"citationItems":[{"id":944,"uris":["http://zotero.org/users/7083350/items/B42G68P6"],"itemData":{"id":944,"type":"document","title":"Cervical_Cancer_Screening_flier.pdf","URL":"https://www.swedish.org/~/media/Files/Providence%20Swedish/PDFs/Cancer/Cervical_Cancer_Screening_flier.pdf","accessed":{"date-parts":[["2022",9,16]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (13) . White et al uurin g näitas, et emakakaelavähki haigestumus ei langenud enne 85 eluaastat ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VHIw3BRV","properties":{"formattedCitation":"(15)","plainCitation":"(15)","noteIndex":0},"citationItems":[{"id":945,"uris":["http://zotero.org/users/7083350/items/L3G75JJF"],"itemData":{"id":945,"type":"article-journal","abstract":"INTRODUCTION: Leading professional organizations recommend cervical cancer screening for average-risk women aged 21-65 years. For average-risk women aged >65 years, routine screening may be discontinued if \"adequate\" screening with negative results is documented. Screening is recommended after age 65 years for women who do not meet adequate prior screening criteria or are at special risk.\nMETHODS: Authors examined the most recent cervical cancer incidence data from two federal cancer surveillance programs for all women by age and race, corrected for hysterectomy status. The 2013 and 2015 National Health Interview Surveys were analyzed in 2016 to examine the proportion of women aged 41-70 years without a hysterectomy who reported that they never had a Pap test or that their most recent Pap test was >5 years ago (not recently screened).\nRESULTS: The incidence rate for cervical cancer among older women, corrected for hysterectomy status, did not decline until age ≥85 years. The proportion not recently screened increased with age, from 12.1% for women aged 41-45 years to 18.4% for women aged 61-65 years.\nCONCLUSIONS: Even among women within the recommended age range for routine screening, many are not up to date, and a substantial number of women approach the \"stopping\" age for cervical cancer screening without an adequate prior screening history. Efforts are needed to reach women who have not been adequately screened, including women aged >65 years, to prevent invasive cervical cancer cases and deaths among older women.","container-title":"American Journal of Preventive Medicine","DOI":"10.1016/j.amepre.2017.02.024","ISSN":"1873-2607","issue":"3","journalAbbreviation":"Am J Prev Med","language":"eng","note":"PMID: 28473240\nPMCID: PMC5821231","page":"392-395","source":"PubMed","title":"Cervical Cancer Screening and Incidence by Age: Unmet Needs Near and After the Stopping Age for Screening","title-short":"Cervical Cancer Screening and Incidence by Age","volume":"53","author":[{"family":"White","given":"Mary C."},{"family":"Shoemaker","given":"Meredith L."},{"family":"Benard","given":"Vicki B."}],"issued":{"date-parts":[["2017",9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (15) . Samuti näidati uuringus, et sõeluuringust eemale jäänute protsent suurenes vanusega ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"BblbOgAp","properties":{"formattedCitation":"(15)","plainCitation":"(15)","noteIndex":0},"citationItems":[{"id":945,"uris":["http://zotero.org/users/7083350/items/L3G75JJF"],"itemData":{"id":945,"type":"article-journal","abstract":"INTRODUCTION: Leading professional organizations recommend cervical cancer screening for average-risk women aged 21-65 years. For average-risk women aged >65 years, routine screening may be discontinued if \"adequate\" screening with negative results is documented. Screening is recommended after age 65 years for women who do not meet adequate prior screening criteria or are at special risk.\nMETHODS: Authors examined the most recent cervical cancer incidence data from two federal cancer surveillance programs for all women by age and race, corrected for hysterectomy status. The 2013 and 2015 National Health Interview Surveys were analyzed in 2016 to examine the proportion of women aged 41-70 years without a hysterectomy who reported that they never had a Pap test or that their most recent Pap test was >5 years ago (not recently screened).\nRESULTS: The incidence rate for cervical cancer among older women, corrected for hysterectomy status, did not decline until age ≥85 years. The proportion not recently screened increased with age, from 12.1% for women aged 41-45 years to 18.4% for women aged 61-65 years.\nCONCLUSIONS: Even among women within the recommended age range for routine screening, many are not up to date, and a substantial number of women approach the \"stopping\" age for cervical cancer screening without an adequate prior screening history. Efforts are needed to reach women who have not been adequately screened, including women aged >65 years, to prevent invasive cervical cancer cases and deaths among older women.","container-title":"American Journal of Preventive Medicine","DOI":"10.1016/j.amepre.2017.02.024","ISSN":"1873-2607","issue":"3","journalAbbreviation":"Am J Prev Med","language":"eng","note":"PMID: 28473240\nPMCID: PMC5821231","page":"392-395","source":"PubMed","title":"Cervical Cancer Screening and Incidence by Age: Unmet Needs Near and After the Stopping Age for Screening","title-short":"Cervical Cancer Screening and Incidence by Age","volume":"53","author":[{"family":"White","given":"Mary C."},{"family":"Shoemaker","given":"Meredith L."},{"family":"Benard","given":"Vicki B."}],"issued":{"date-parts":[["2017",9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (15) . Siit joonistub välja probleem, et kui naiste hõlmatus sõeluuringutega on juba varasemalt väikene, siis oleks vajalik ka teostada sõeluuringuid vanemas vanuserühmas, et testida ära naised, keda eelnevalt pole testitud . Kuigi tõenäosus, et 65+ naised nakatuvad HPV’ga on väikene , siis on siiski ka nende hulgas uusi emakakaelavähki haigestumisi ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"AEPL5xDt","properties":{"formattedCitation":"(14)","plainCitation":"(14)","noteIndex":0},"citationItems":[{"id":940,"uris":["http://zotero.org/users/7083350/items/ZXZR3ZXL"],"itemData":{"id":940,"type":"document","title":"cervical_cancer_en-Nov_2021.pdf"}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (14) . Joonis 3. Uute emakakaelavähi juhtumite jagunemine vanuseti aastal 2020 Euroopas. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"SJ83KENe","properties":{"formattedCitation":"(14)","plainCitation":"(14)","noteIndex":0},"citationItems":[{"id":940,"uris":["http://zotero.org/users/7083350/items/ZXZR3ZXL"],"itemData":{"id":940,"type":"document","title":"cervical_cancer_en-Nov_2021.pdf"}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (14) Kasutatud kirjandus ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY 1. Statistika: ligi pooled surmadest olid 2020. aastal tingitud vereringeelundite haigustest | Tervise Arengu Instituut [Internet]. [tsiteeritud 27. juuli 2022]. Available at: https://www.tai.ee/et/uudised/statistika-ligi-pooled-surmadest-olid-2020-aastal-tingitud-vereringeelundite-haigustest 2. RINNAVÄHI SÕELUURING - Soeluuring.ee [Internet]. [tsiteeritud 27. juuli 2022]. Available at: https://soeluuring.ee/rinnavahk/ 3. PK30: Pahaloomuliste kasvajate haigestumuse vanuskordajad 100 000 elaniku kohta paikme ja soo järgi. PxWeb [Internet]. [tsiteeritud 27. juuli 2022]. Available at: https://statistika.tai.ee/pxweb/et/Andmebaas/Andmebaas__02Haigestumus__04PahaloomulisedKasvajad/PK30.px/sortedtable/tableViewSorted/ 4. VSR02: Rinnavähi sõeluuringu sihtrühma hõlmatus mammograafilise uuringuga vanuse järgi. PxWeb [Internet]. [tsiteeritud 27. juuli 2022]. Available at: https://statistika.tai.ee/pxweb/et/Andmebaas/Andmebaas__02Haigestumus__07Soeluuringud/VSR02.px/table/tableViewLayout2/ 5. Breast cancer screening differs among Member States [Internet]. [tsiteeritud 27. juuli 2022]. Available at: https://ec.europa.eu/eurostat/web/products-eurostat-news/-/DDN-20200109-1 6. Altobelli E, Lattanzi A. Breast cancer in European Union: An update of screening programmes as of March 2014 (Review). Int J Oncol. 1. november 2014;45(5):1785–92. 7. European Commission Initiative on Breast and Colorectal Cancer [Internet]. [tsiteeritud 28. juuli 2022]. Available at: https://healthcare-quality.jrc.ec.europa.eu 8. ECIBC_GLs_EtD_screening_70-74.pdf [Internet]. [tsiteeritud 27. juuli 2022]. Available at: https://healthcare-quality.jrc.ec.europa.eu/sites/default/files/Guidelines/EtDs/ECIBC_GLs_EtD_screening_70-74.pdf 9. Jayasekera J, Mandelblatt JS. Systematic Review of the Cost Effectiveness of Breast Cancer Prevention, Screening, and Treatment Interventions. J Clin Oncol. 1. veebruar 2020;38(4):332–50. 10. Vähi sõeluuringud naistele [Internet]. Haigekassa. 2017 [tsiteeritud 16. september 2022]. Available at: https://www.haigekassa.ee/soeluuring 11. Chrysostomou AC, Stylianou DC, Constantinidou A, Kostrikis LG. Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing. Viruses. detsember 2018;10(12):729. 12. Fontham ETH, Wolf AMD, Church TR, Etzioni R, Flowers CR, Herzig A, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin. 2020;70(5):321–46. 13. Cervical_Cancer_Screening_flier.pdf [Internet]. [tsiteeritud 16. september 2022]. Available at: https://www.swedish.org/~/media/Files/Providence%20Swedish/PDFs/Cancer/Cervical_Cancer_Screening_flier.pdf 14. Cervical cancer burden in EU-27 fact sheet. Available at: https://ecis.jrc.ec.europa.eu/pdf/factsheets/cervical_cancer_en-Nov_2021.pdf . 15. White MC, Shoemaker ML, Benard VB. Cervical Cancer Screening and Incidence by Age: Unmet Needs Near and After the Stopping Age for Screening. Am J Prev Med. september 2017;53(3):392–5.
Saatja: Laila Talunik <
[email protected]>
Saadetud: 18.10.2022 16:23
Adressaat: SM Info <
[email protected]>
Teema: FW: palun ametlikult sisse võtta.
From: Andres Ergma <
[email protected]> Sent: Tuesday, October 11,
2022 4:55 PMTo: Laila Talunik <
[email protected]>Subject: FW:
Tere!
Edastan ministrile saadetud kirja.
Tervitades,
Andres Ergma
Eesti Pensionäride Ühenduste Lii
From: Andres Ergma [] Sent: Thursday, September 15, 2022 6:24 PMTo:
'
[email protected]'Cc: '
[email protected]'Subject: FW:
Lugupeetud tervise-ja tööminister hr. Peep Peterson,
Seoses naiste oodatava eluea tõusuga on sagenenud
halvaloomuliste kasvajate esmadiagnoosid 65+ vanuste naiste hulgas.
Puht emotsionaalselt raske teema on tõusnud sagedasti käsitletavaks
meie naispensionäride hulgas. Meile saadaolevate andmete järgi oli aastal
2019.a.
naiste hulgas, vanuses 65+ , fikseeritud 465 rinnavähi esmadiagnoosi.
Aasta 2020 oli surmapõhjustest teisel kohal pahaloomulised kasvajad.
Nendest 6% moodustas rinnavähk. Uuringutele ei kutsuta vanemas eas
naisi.
2019 aastal haigestus rinnavähki vanuses 60-64, 169 naist 100000 elaniku
kohta.
Vanuserühmas 70-74 haigestus rinnavähki 231 naist (lühike ülevaade
manuses).
Uuringud on näidanud, et emakakaela vähki haigestumus ei langenud enne 85
eluaastat.
Oleks vajalik testida naisi vanemas eas, sest arvestatav hulk naisi ei
käi
kutse peale uuringutel, mille tõttu halvaloomuliste kasvajate avastamine
jääb hilisemasse eluperioodi.
Eesti Pensionäride Ühenduste Liit teeb ettepaneku tõsta sõeluuringutele
kutsutavate naist vanust kuni 74 eluaastani.
Arvestades ravimeetodite arengut võimaldaks vanusepiiri tõstmine, ka
pahaloomulise kasvaja hilinenud avastamisel, võimaldada
patsiendile arvestatava pikkusega elulisust.
Kuna naistest käib sõeluuringutel 50-60 % kutsututest, ei tohiks olla
probleeme uuringute finantseerimisega eelarve piires.
Tervitades,
Andres Ergma
juhatuse esimees
Eesti Pensionäride Ühenduste Liit