Effect of the national screening program on malignancy status of cervical cancer in Northern Thailand

Cervical cancer has posed a serious problem in Thailand for decades. In 2002, a systematic screening program was implemented under universal healthcare coverage for all Thai women. However, there has been little research on how screening affected particular aspects of cervical cancer, such as stage distribution. This screening program has a target group; therefore, it is necessary to assess stage and incidence trends by age of those within and outside the screening target group. Using trend analysis, we assess in situ and malignant cervical cancers in Northern Thailand to measure changes after implementation of the national screening program. While incidence of malignant cancers is decreasing and incidence of in situ tumors is increasing across all age groups, women above age 60 still experience a high incidence of malignant tumors. The screening program is successful in the target group at downshifting the stage distribution of malignant tumors and reducing incidence of malignant tumors with in situ cases being captured. However, the high incidence of malignant tumors in women over age 60 will continue to be clinically relevant for cervical cancer management until younger generations undergoing screening enter this age group.