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© 2024 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background and Objectives: Burden of cervical cancer in Central and Eastern Europe is higher than in other parts of Europe. We analyzed cervical cancer epidemiology in Serbia and Bosnia and Herzegovina (the Federation of Bosnia and Herzegovina and the Republic of Srpska) from January 2016 to December 2020, exploring the role of available sociodemographic factors and healthcare service parameters on incidence and mortality rates, using an ecological approach based on aggregated data. Materials and Methods: Incidence and mortality rates are standardized using the method of direct standardization with the World-ASR-W. Administrative units are grouped by tertiles of incidence and mortality to explore sociodemographic factors and healthcare parameters across these groups. Results: Average age-standardized incidence rates of cervical cancer per 100,000 females were 19.28 in Serbia, 12.48 in the Federation of Bosnia and Herzegovina, and 22.44 in the Republic of Srpska. Mortality rates per 100,000 females were 6.67, 5.22, and 4.56 in Serbia, the Federation of Bosnia and Herzegovina, and the Republic of Srpska, respectively. Several parameters of sociodemographics and health service usage differed significantly across units grouped by tertiles based on incidence level, i.e., female population ≥ 15 years old (p = 0.028), population density (p = 0.046), percent of gynecologists in the primary healthcare (p = 0.041), number of gynecologists per 10,000 females ≥ 15 years (p = 0.007), and the area-to-gynecologist ratio (p = 0.010). A moderate negative correlation was found between incidence and population density (rho = −0.465, p = 0.017), and a moderate positive correlation between incidence and area-to-gynecologist ratio (rho = 0.534, p = 0.005). Conclusions: Cervical cancer remains a leading cause of cancer among women in developing countries. Implementing tailored activities, such as educational programs, preventive services, and investments in healthcare infrastructure, particularly at the administrative units’ level, can help in reducing health disparities and improving health outcomes.

Details

Title
Relationship Between Population Density, Availability of Gynecological Services, and Cervical Cancer Incidence and Mortality Across Administrative Units in Serbia and Bosnia and Herzegovina During 2016–2020
Author
Vuković, Vladimir 1   VIAFID ORCID Logo  ; Štrbac, Mirjana 2   VIAFID ORCID Logo  ; Ristić, Mioljub 1   VIAFID ORCID Logo  ; Skočibušić, Siniša 3   VIAFID ORCID Logo  ; Cilović-Lagarija, Šeila 4   VIAFID ORCID Logo  ; Aćimović, Jela 5 ; Šiljak, Slađana 6   VIAFID ORCID Logo  ; Perišić, Snežana Živković 7 ; Nikolić, Nataša 1   VIAFID ORCID Logo  ; Ljubičić, Stefan 2 ; Pustahija, Tatjana 1 ; Rajčević, Smiljana 1 ; Patić, Aleksandra 1   VIAFID ORCID Logo  ; Dugandžija, Tihomir 8 ; Mandić, Aljoša 8 ; Petrović, Vladimir 1   VIAFID ORCID Logo 

 Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia; [email protected] (M.Š.); [email protected] (M.R.); [email protected] (N.N.); [email protected] (S.L.); [email protected] (T.P.); [email protected] (S.R.); [email protected] (A.P.); [email protected] (V.P.); Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; [email protected] (T.D.); [email protected] (A.M.) 
 Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia; [email protected] (M.Š.); [email protected] (M.R.); [email protected] (N.N.); [email protected] (S.L.); [email protected] (T.P.); [email protected] (S.R.); [email protected] (A.P.); [email protected] (V.P.) 
 Institute for Public Health of the Federation of Bosnia and Herzegovina, 71000 Sarajevo, Bosnia and Herzegovina; [email protected] (S.S.); [email protected] (Š.C.-L.); Faculty of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina 
 Institute for Public Health of the Federation of Bosnia and Herzegovina, 71000 Sarajevo, Bosnia and Herzegovina; [email protected] (S.S.); [email protected] (Š.C.-L.) 
 Public Health Institute of the Republic of Srpska, 78000 Banja Luka, Bosnia and Herzegovina; [email protected] (J.A.); [email protected] (S.Š.); Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina 
 Public Health Institute of the Republic of Srpska, 78000 Banja Luka, Bosnia and Herzegovina; [email protected] (J.A.); [email protected] (S.Š.) 
 Institute of Public Health of Serbia “Dr Milan Jovanović Batut”, 11000 Belgrade, Serbia; [email protected] 
 Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; [email protected] (T.D.); [email protected] (A.M.); Oncology Institute of Vojvodina, 21204 Sremska Kamenica, Serbia 
First page
1987
Publication year
2024
Publication date
2024
Publisher
MDPI AG
ISSN
1010660X
e-ISSN
16489144
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3149703613
Copyright
© 2024 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.