Before Time – Empowering Women and Communities for Protection Against Cervical Cancer

 

 

 

The Before Time – Empowering Women and Communities for Protection Against Cervical Cancer project was approved for co-financing from the Interreg VI-A IPA Croatia-Bosnia and Herzegovina-Montenegro program. The project started on September 1, 2024 and will last 30 months, until February 28, 2027. The official start will be marked by the Kick-off meeting, which will be held in December 2024 in Montenegro. The project is coordinated by the Zadar Institute of Public Health, and a total of six partners from three countries participate.

A challenge to which the project contributes to solving

At the end of 2020., the World Health Organization (WHO) launched a global initiative to accelerate the elimination of cervical cancer, according to which the prevention strategy combines three key preventive interventions, according to which the following goals should be achieved by 2030: vaccination against HPV 90% of girls and a significant percentage of boys up to the age of 15, screening testing of 70% of women up to the age of 35 and retesting up to the age of 45, and timely treatment of 90% of all diagnosed premalignant lesions and invasive cancers. Numerous other European documents include recommendations on strengthening the prevention of cervical cancer through the implementation of organized screening for cervical cancer and vaccination against HPV, the main cause of cervical cancer. Although achieving the complete removal of cervical cancer in practice is not possible, with the existing preventive tools it is possible to significantly reduce the number of new cases, and the WHO defines the achievement of this goal as an incidence rate or the number of new cases per year of less than 4 per 100,000 women.

Incidence and mortality from cervical cancer in the world in countries of low and medium level of development are still very high – there cervical cancer is the second malignant cause of death in women. According to the estimates of the European Commission for the year 2022, in comparison with EU member states, Croatia ranks 11th in terms of incidence and 12th in terms of mortality from cervical cancer (comparison of age-standardized rates – ASR). In recent years, about 300 cases of cervical cancer have been recorded in Croatia, which is a rate of about 13 per 100,000 women, and about 120 deaths from cervical cancer per year. About a third of recorded cases of cervical cancer are detected in the regionally extended stage, and about eight percent with distant metastases, when the chances of a successful cure are lower.

Main goal of the project and areas of activity

The main goal of the project is to strengthen prevention and early detection of pre-stage cancer and initial cancer of the cervix before invasive cervical cancer develops through information, education, encouragement of vaccination against the Human Papilloma Virus (HPV), informing about the importance of regular preventive gynecological examinations and motivating and encouraging to participate in them

The project will focus on the main measures of primary and secondary prevention of cervical cancer: education and information about the risks and methods of protection, vaccination against HPV and screening tests for premalignant and malignant changes on the mucous membrane of the cervix, i.e. the method of preventing cancer through early detection and treatment premalignant cell changes and initial cervical cancer, which, if left untreated, can lead to invasive cervical cancer and serious health damage. The project also includes the creation of a communication strategy to inform about the importance of HPV vaccination and preventive gynecological examinations. In addition, the self-sampling pilot project protocol for HPV testing in Zadar County will be developed and tested. The project represents a significant contribution to the strengthening of prevention and education on the prevention of cervical cancer and the improvement of health care for women in Croatia, Bosnia and Herzegovina and Montenegro.

Users

Beneficiaries of the activities and results of this project will be women, young people and their parents in implementing countries, pilot regional areas that will participate in the creation and implementation of screening with self-sampling, and experts from state institutions and civil society organizations that will participate in the implementation of capacity-building activities.

Financing

The total value of the project is €1,234,582.20, with a co-financing rate of 85% through grants, while the remaining 15% will be provided from the participants own funds.

Access to implementation with international cooperation

Project activities are designed in such a way as to encourage and use opportunities for cooperation and exchange of experiences between the countries involved in the implementation of the project. International cooperation enables the exchange of knowledge, experiences and ideas among partners from different countries, which will contribute to more effective achievement of cervical cancer prevention goals. The common online platform Educa will ensure the visibility and availability of project results and support cooperation between partners and potential collaborators and users.

Basic information about the project

Project name: Empowering Women and Communities for Protection Against Cervical Cancer

Project acronym: Before Time

Operation ID: HR-BA-ME00194

Program: Interreg VI-A IPA Program Croatia – Bosnia and Herzegovina – Montenegro 2021 – 2027 (1st Call for Proposals)

Priority axis: 3 – Accessible and resilient health services

Specific objective: RSO4.5 – Ensuring equal access to health care and fostering resilience of health systems, including primary care, and promoting the transition from institutional to family and community based care

Leading partner: Institute of Public Health Zadar (Zadar, Croatia)

Project partners:

  1. Institute of Public Health of Montenegro (Podgorica, Montenegro)
  2. Health center Mostar (Mostar, Bosnia and Herzegovina)
  3. Health center Tivat (Tivat, Montenegro)
  4. Institute of Mediterranean Economic Perspectives (Split, Croatia)
  5. Croatian Institute of Public Health (Zagreb, Croatia)

The main outcomes of the project are:

  • Development of a protocol for the implementation of the HPV testing pilot project
  • Implementation of pilot projects for cervical cancer screening with self-sampling of test samples
  • Implementation of educational programs, campaigns and strengthening of the capacity of experts in the field by advocating the transition from institutional to family and community service
  • The project will be dedicated to the education of healthcare workers and experts in the field of health promotion and primary and secondary prevention:

Primary prevention will focus on teenagers, adolescents, their parents and young people up to 25 years of age, through campaigns on HPV vaccination and health promotion.

Secondary prevention will be aimed at women aged 30-64 through inviting and encouraging response to screening and early detection of pre-cancer and initial cervical cancer in order to prevent the occurrence of invasive and widespread cancer and timely start of treatment, when treatment outcomes are more favorable .

The activities of the Croatian Institute of Public Health (CIPH) as part of the project will be the creation of two educational and informative videos with subtitles in English that will be used for educational and promotional information activities on the importance of HPV vaccination and screening tests, including instructions on how to take a sample correctly for testing at home, which will raise citizens  awareness. Also, CIPH, in cooperation with partners, will develop recommendations for improving the implementation of HPV vaccination and organized screening for cervical cancer.

Duration of the project: 1.9.2024. – 28.2.2027.

Total value of the project: EUR 1,234,582.20

Budget of the Croatian Institute for Public Health: EUR 143,301.90

Project manager at HZJZ: prim. Tatjana Nemeth Blažić, MD

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