Cervical Cancer Prevention Challenges and Barriers to Cervical Cancer Screening and HPV Vaccinations in Ukraine and Eastern Europe — Oak Academic Publishing
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Cervical Cancer Prevention Challenges and Barriers to Cervical Cancer Screening and HPV Vaccinations in Ukraine and Eastern Europe
Department of Gynecology, Obstetrics and Gynecological Oncology, Medical University of Silesia, Katowice, Poland
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Department of Surgery and Critical Care, Massachusetts General Hospital, Boston, USA
,
Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, USA
1 Department of Gynecology, Obstetrics and Gynecological Oncology, Medical University of Silesia, Katowice, Poland
2 Department of Surgery and Critical Care, Massachusetts General Hospital, Boston, USA
3 Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, USA
Objectives: To identify the obstacles and issues that hinder effective cancer prevention efforts in Ukraine. The study aims to provide a comprehensive assessment of the barriers to cancer prevention, including both infrastructure and behavioral factors, and identify potential solutions to address these challenges. Study Design: Comprehensive literature review. Methods: The following databases were searched: National Center for Biotechnology Information (NCBI) and PubMed (U.S. National Library of Medicine at the National Institutes of Health). The keywords used in the search included “Cervical Cancer”, “Human Papillomavirus Vaccination (HPV)”, “Ukraine”, “Eastern Europe”, “Healthcare Infrastructure in Disasters”, “Cervical Cancer Prevention”, “Pap Smear”, and “HPV Testing”. Results: A total of 3500 articles were screened. A total of 65 articles met the inclusion criteria. Limited public awareness and limited access to vaccination and screening, combined with inadequate treatment facilities lead to higher rates of cervical cancer. The COVID pandemic, war with Russia, and the Chernobyl disaster are significant factors for the low level of vaccination in Ukraine. Conclusion: The prevention and treatment of cervical cancer in Ukraine face significant challenges due to the inadequate HPV vaccination rates and screening by cytology. Efforts to improve funding and increase education of both the population and health care providers are necessary to increase interventions such as HPV vaccination, cervical cytology, and HPV testing to reduce cervical cancer rates in Ukraine.
KeywordsCervical CancerHuman Papillomavirus VaccinationUkraineEastern EuropeHealthcare Infrastructure in DisastersCervical Cancer PreventionPap SmearHPV Testing
Yousefi, Z., Aria, H., Ghaedrahmati, F., Bakhtiari, T., Azizi, M., Bastan, R., et al. (2022) An Update on Human Papilloma Virus Vaccines: History, Types, Protection, and Efficacy. Frontiers in Immunology, 12, Article ID: 805695. https://doi.org/10.3389/fimmu.2021.805695
Perkins, R.B., Guido, R.L., Saraiya, M., Sawaya, G.F., Wentzensen, N., Schiffman, M. and Feldman, S. (2021) Summary of Current Guidelines for Cervical Cancer Screening and Management of Abnormal Test Results: 2016-2020. Journal of Women’s Health (Larchmt), 30, 5-13. https://doi.org/10.1089/jwh.2020.8918
Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A. and Bray, F. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. https://doi.org/10.3322/caac.21660
IARC: International Agency for Research on Cancer (World Health Organization) Global Cancer Observatory. https://gco.iarc.fr
El Saghir, N.S., Soto Pérez de Celis, E., Fares, J.E. and Sullivan, R. (2018) Cancer Care for Refugees and Displaced Populations: Middle East Conflicts and Global Natural Disasters. American Society of Clinical Oncology Educational Book, 38, 433-440. https://doi.org/10.1200/EDBK_201365
CIA Factbook Ukraine (2023). https://www.cia.gov/the-world-factbook/countries/ukraine
National Cancer Registry of Ukraine. http://www.ncru.inf.ua
Zhdan, V.M., Holovanova, I.A., Vovk, O.Y. and Korosh, M.V. (2021) Relationship between Cervical Cancer and the Level of Preventive Oncological Examinations. Wiadomosci Lekarskie, 74, 1428-1432. https://doi.org/10.36740/WLek202106126
Bray, F., Lortet-Tieulent, J., Znaor, A., Brotons, M., Poljak, M. and Arbyn, M. (2013) Patterns and Trends in Human Papillomavirus-Related Diseases in Central and Eastern Europe and Central Asia. Vaccine, 31, H32-H45. https://doi.org/10.1016/j.vaccine.2013.02.071 https://www.gardasil9.com/adults/cost/31
Ehorova, Y.V., Dыkhno, Yu.A. and Krykunova, L.Y. (2010) Rak sheiky matky: Zabolevaemost, klynyka, dyahnostyka, lechenye. Nauka, Novosybyrsk, 84 p.
Ryzhov, A., Bray, F., Ferlay, J., Fedorenko, Z., Goulak, L., Gorokh, Y., et al. (2020) Recent Cancer Incidence Trends in Ukraine and Short-Term Predictions to 2022. Cancer Epidemiology, 65, Article ID: 101663. https://doi.org/10.1016/j.canep.2019.101663
Ferlay, J., Colombet, M. and Bray, F. (2018) Cancer Incidence in Five Continents, CI5plus: IARC CancerBase No. 9. International Agency for Research on Cancer, Lyon.
Rynhach, N., Kuryk, O., Nesvitaylova, K., Mostiuk, O., Cherkasova, L. and Bazdyriev, V. (2021) Peculiarities of Mortality Due to Neoplasms in Ukraine: What Are the Threats of COVID-19 Pandemic? Georgian Medical News, No. 321, 62-69.
Bucchi, D., Chiavarini, M., Bianconi, F., Galeotti, M.E., Gili, A. and Stracci, F. (2019) Immigration, Screening, and Cervical Cancer Incidence: An Application of Age-Period-Cohort Analysis. European Journal of Cancer Prevention, 28, 529-536. https://doi.org/10.1097/CEJ.0000000000000495
Tommasino, M. (2014) The Human Papillomavirus Family and Its Role in Carcinogenesis. Seminars in Cancer Biology, 26, 13-21. https://doi.org/10.1016/j.semcancer.2013.11.002
Rogovskaya, S.I., Shabalova, I.P., Mikheeva, I.V., Minkina, G.N., Podzolkova, N.M., Shipulina, O.Y., et al. (2013) Human Papillomavirus Prevalence and Type-Distribution, Cervical Cancer Screening Practices and Current Status of Vaccination Implementation in Russian Federation, the Western Countries of the Former Soviet Union, Caucasus Region and Central Asia. Vaccine, 31, H46-H58. https://doi.org/10.1016/j.vaccine.2013.06.043
Columbia Maiman School of Public Health (2020) Ukraine Summary. https://www.publichealth.columbia.edu/research/others/comparative-health-policy-library/ukraine-summary
Lekhan, V., Rudiy, V. and Richardson, E. (2010) Ukraine: Health System Review. Health Systems in Transition, 12, 1-183, xiii-xiv.
Lekhan, V., Rudiy, V., Shevchenko, M., Nitzan Kaluski, D. and Richardson, E. (2015) Ukraine: Health System Review. Health Systems in Transition, 17, 1-154.
Teremetskyi, V., Muzychuk, O., Salmanova, O., Kaznacheyeva, D. and Knysh, S. (2018) Strengthening of Contractual Principles within Legal Relations between a Patient and a Medical Institution While Reforming the Health Care System in Ukraine. Georgian Medical News, No. 284, 155-159. (In Russian)
Knysh, S.V., Gusarov, S.M., Shelukhin, N.L., Kharaberiush, I.F. and Bila, V.R. (2019) Modernization of State Administration System in the Health Care Sphere of Ukraine. Wiadomosci Lekarskie, 72, 887-891. https://doi.org/10.36740/WLek201905129
Deshko, L., Vasylchenko, O., Sherbak, I., Galai, V. and Medvid, A. (2021) Ukraine’s International Liabilities on Initiation of Measures for Public Health Protection and the Role of Local Authorities in Implementation of Health Care Policy. Georgian Medical News, No. 312, 163-168.
Gruzieva, T.S., Hrechyshkina, N.V., Inshakova, H.V., Dubovyk, V.Y. and Kalashnykova, N.M. (2022) Development of the Public Health System in the Conditions of Current Challenges and Threats. Wiadomosci Lekarskie, 75, 1130-1135. https://doi.org/10.36740/WLek202205114
Roborgh, S., Coutts, A.P., Chellew, P., Novykov, V. and Sullivan, R. (2022) Conflict in Ukraine Undermines an Already Challenged Health System. The Lancet, 399, 1365-1367. https://doi.org/10.1016/S0140-6736(22)00485-8
Petersen, Z., Jaca, A., Ginindza, T.G., Maseko, G., Takatshana, S., Ndlovu, P., et al. (2022) Barriers to Uptake of Cervical Cancer Screening Services in Low-and-Middle-Income Countries: A Systematic Review. BMC Women’s Health, 22, Article No. 486. https://doi.org/10.1186/s12905-022-02043-y
Bruni, L., Serrano, B., Roura, E., Alemany, L., Cowan, M., Herrero, R., et al. (2022) Cervical Cancer Screening Programmes and Age-Specific Coverage Estimates for 202 Countries and Territories Worldwide: A Review and Synthetic Analysis. The Lancet Global Health, 10, e1115-e1127. https://doi.org/10.1016/S2214-109X(22)00241-8
Doroshenko, O., Khan, O., Fraser-Hurt, N., Wilson, D. and Zhao, F. (2019) Cervical Cancer in Ukraine: The Continuum of Care and Implications for Action. https://documents.worldbank.org/en/publication/documents-reports/documentdetail/794431547241531146/cervical-cancer-in-ukraine-the-continuum-of-care-and-implications-for-action
Sulaieva, O., Dudin, O., Botsun, P., Pischanska, S., Karpachova, V., Omelianenko, I., et al. (2023) The Detrimental Consequences of Two Consecutive Disasters Impacting Cytopathology in Ukraine: COVID Followed by the War. Cytopathology. https://doi.org/10.1111/cyt.13236
Crawshaw, A.F., Farah, Y., Deal, A., Rustage, K., Hayward, S.E., Carter, J., et al. (2022) Defining the Determinants of Vaccine Uptake and Undervaccination in Migrant Populations in Europe to Improve Routine and COVID-19 Vaccine Uptake: A Systematic Review. The Lancet Infectious Diseases, 22, e254-e266. https://doi.org/10.1016/S1473-3099(22)00066-4
Ganczak, M., Kalinowski, P., Pasek, O., Duda-Duma, L., Sobieraj, E., Golawski, J., et al. (2022) Health System Barriers to Child Mandatory and Optional Vaccination among Ukrainian Migrants in Poland in the Context of MMR and HPV Vaccines—A Qualitative Study. International Journal of Environmental Research and Public Health, 20, Article No. 712. https://doi.org/10.3390/ijerph20010712
CDC, Centers for Disease Control and Prevention. HPV Vaccination Recommendations. https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html#:~:text=HPV%20Vaccine%20%5B1page%5D-,Dosing%20Schedules,third%20dose%20of%20HPV%20vaccine
Kostaras, D., Karampli, E. and Athanasakis, K. (2019) Vaccination against HPV Virus: A Systematic Review of Economic Evaluation Studies for Developed Countries. Expert Review of Pharmacoeconomics & Outcomes Research, 19, 147-158. https://doi.org/10.1080/14737167.2019.1555039
Outterson, K. and Kesselheim, A.S. (2008) Market-Based Licensing for HPV Vaccines in Developing Countries. Health Affairs (Millwood), 27, 130-139. https://doi.org/10.1377/hlthaff.27.1.130
Patel, C., Brotherton, J.M., Pillsbury, A., Jayasinghe, S., Donovan, B., Macartney, K. and Marshall, H. (2018) The Impact of 10 Years of Human Papillomavirus (HPV) Vaccination in Australia: What Additional Disease Burden Will a Nonavalent Vaccine Prevent? Eurosurveillance, 23, Article ID: 1700737. https://doi.org/10.2807/1560-7917.ES.2018.23.41.1700737
Gardasil. Information about Costs. https://www.gardasil9.com/adults/cost
Oyedeji, O., Maples, J.M., Gregory, S., Chamberlin, S.M., Gatwood, J.D., Wilson, A.Q., Zite, N.B. and Kilgore, L.C. (2021) Pharmacists’ Perceived Barriers to Human Papillomavirus (HPV) Vaccination: A Systematic Literature Review. Vaccines (Basel), 9, Article No. 1360. https://doi.org/10.3390/vaccines9111360
Hryshchuk, S., Harlinska, A. and Korneichuk, A. (2020) Evaluation of Economic Feasibility of Cancer Prevention by Vaccination from Papillomavirus Infection in Ukraine. RAD Conference Proceedings, 4, 155-160. https://doi.org/10.21175/RadProc.2020.32
Altobelli, E., Rapacchietta, L., Profeta, V.F. and Fagnano, R. (2019) HPV-Vaccination and Cancer Cervical Screening in 53 WHO European Countries: An Update on Prevention Programs According to Income Level. Cancer Medicine, 8, 2524-2534. https://doi.org/10.1002/cam4.2048
Zakharchenko, O., Avramenko, R., Zakharchenko, A., Korobchuk, A., Fedushko, S., Syerov, Y. and Trach, O. (2022) Multifaceted Nature of Social Media Content Propagating COVID-19 Vaccine Hesitancy: Ukrainian Case. Procedia Computer Science, 198, 682-687. https://doi.org/10.1016/j.procs.2021.12.306
Ganczak, M., Bielecki, K., Drozd-Dabrowska, M., Topczewska, K., Biesiada, D., Molas-Biesiada, A., Dubiel, P. and Gorman, D. (2021) Vaccination Concerns, Beliefs and Practices among Ukrainian Migrants in Poland: A Qualitative Study. BMC Public Health, 21, Article No. 93. https://doi.org/10.1186/s12889-020-10105-9
Wadman, M. (2019) Measles Epidemic in Ukraine Drove Troubling European Year. Science, 363, 677-678. https://doi.org/10.1126/science.363.6428.677
Troiano, G., Torchia, G. and Nardi, A. (2022) Vaccine Hesitancy among Ukrainian Refugees. Journal of Preventive Medicine and Hygiene, 63, E566-E572.
Mipatrini, D., Stefanelli, P., Severoni, S. and Rezza, G. (2017) Vaccinations in Migrants and Refugees: A Challenge for European Health Systems. A Systematic Review of Current Scientific Evidence. Pathogens and Global Health, 111, 59-68. https://doi.org/10.1080/20477724.2017.1281374
Chernyshov, P.V. and Semushyna, T. (2020) Differences in Human Papilloma Virus Vaccination Prevalence, Testing, Knowledge on Vaccination, Cancer Awareness and Sexual Activities between Male and Female Medical and Non-Medical Students. The Journal of the European Academy of Dermatology and Venereology, 34, 2902-2906. https://doi.org/10.1111/jdv.16845
Chernyshov, P.V. and Humenna, I. (2019) Human Papillomavirus: Vaccination, Related Cancer Awareness, and Risk of Transmission among Female Medical Students. Acta Dermatovenerologica Alpina Pannonica et Adriatica, 28, 75-79. https://doi.org/10.15570/actaapa.2019.19
Chernyshov, P.V., Semushyna, T., Verbytska, L., Fedorych, P.V., Avramenko, A., Osaulenko, T. and Zolotonosha, Y.V. (2022) Human Papilloma Virus Vaccination Knowledge, Prevalence, Risk Factors, and HPV Detection in 18 - 26 and 27 - 45-Year-Old Men and Women. Acta Dermatovenerologica Croatica, 30, 203-208.
Sidel, V.W. and Levy, B.S. (2008) The Health Impact of War. International Journal of Injury Control and Safety Promotion, 15, 189-195. https://doi.org/10.1080/17457300802404935
Vu, A., Adam, A., Wirtz, A., Pham, K., Rubenstein, L., Glass, N., Beyrer, C. and Singh, S. (2014) The Prevalence of Sexual Violence among Female Refugees in Complex Humanitarian Emergencies: A Systematic Review and Meta-Analysis. PLOS Currents, 6.
Geiling, J., Burkle, F.M., West, T.E., Uyeki, T.M., Amundson, D., Dominguez-Cherit, G., Gomersall, C.D., Lim, M.L., Luyckx, V., Sarani, B., Christian, M.D., Devereaux, A.V., Dichter, J.R., Kissoon, N. and Task Force for Mass Critical Care (2014) Resource-Poor Settings: Response, Recovery, and Research: Care of the Critically Ill and Injured during Pandemics and Disasters: CHEST Consensus Statement. Chest, 146, e168S-e177S. https://doi.org/10.1378/chest.14-0745
Quinn, V.J.M., Dhabalia, T.J., Roslycky, L.L., Wilson, V.J.M., Hansen, J.C., Hulchiy, O., et al. (2022) COVID-19 at War: The Joint Forces Operation in Ukraine. Disaster Medicine and Public Health Preparedness, 16, 1753-1760. https://doi.org/10.1017/dmp.2021.88
Saenko, V., Ivanov, V., Tsyb, A., Bogdanova, T., Tronko, M., Demidchik, Y. and Yamashita, S. (2011) The Chernobyl Accident and Its Consequences. Clinical Oncology (Royal College of Radiologists), 23, 234-243. https://doi.org/10.1016/j.clon.2011.01.502
Prysyazhnyuk, A.Y., Gulak, L.O., Gritchenko, V.G. and Fedorenko, Z.P. (2002) Cancer Incidence in Ukraine after the Chernobyl Accident. International Congress Series, 1234, 281-291. https://doi.org/10.1016/S0531-5131(01)00617-3
Zupunski, L., Yaumenenka, A., Ryzhov, A., Veyalkin, I., Drozdovitch, V., Masiuk, S., et al. (2021) Breast Cancer Incidence in the Regions of Belarus and Ukraine Most Contaminated by the Chernobyl Accident: 1978 to 2016. International Journal of Cancer, 148, 1839-1849. https://doi.org/10.1002/ijc.33346
Pukkala, E., Kesminiene, A., Poliakov, S., Ryzhov, A., Drozdovitch, V., Kovgan, L., et al. (2006) Breast Cancer in Belarus and Ukraine after the Chernobyl Accident. International Journal of Cancer, 119, 651-658. https://doi.org/10.1002/ijc.21885
Bennett, B., Repacholi, M. and Carr, Z. (2006) Health Effects of the Chernobyl Accident and Special Health Care Programmes Report of the UN Chernobyl Forum Expert Group “Health”. World Health Organization, Geneva.
Leung, K.M., Shabat, G., Lu, P., Fields, A.C., Lukashenko, A., Davids, J.S. and Melnitchouk, N. (2019) Trends in Solid Tumor Incidence in Ukraine 30 Years after Chernobyl. JCO Global Oncology, 5, 1-10. https://doi.org/10.1200/JGO.19.00099
Borovec, J. (1995) Changes in Incidence of Carcinoma in Situ after the Chernobyl Disaster in Central Europe. Archives of Environmental Contamination and Toxicology, 29, 266-269. https://doi.org/10.1007/BF00212979
Korsakov, A.V., Kryukova, A.E., Troshin, V.P., Milushkina, O.Y. and Lagerev, D.G. (2022) Cervical and Endometrial Cancer Incidence in the Female Population from the Bryansk Region Living in Conditions of Chemical, Radioactive and Combined Environmental Contamination (2000-2020). Life (Basel), 12, Article No. 1488. https://doi.org/10.3390/life12101488
Korsakov, A.V., Golovleva, A.A., Troshin, V.P., Lagerev, D.G. and Pugach, L.I. (2021) Ovarian Malignancies Frequency in the Female Population from the Bryansk Region Living in Conditions of Radioactive, Chemical and Combine Contamination (2000-2020). Life (Basel), 11, Article No. 1272. https://doi.org/10.3390/life11111272
Konrad, R., Bezchlibnyk-Butler, K. and Wodoslawsky, M.D. (2009) Allocation of Aid for Health Institutions in Ukraine: Implications from a Case Study of Chornobyl (Chernobyl) Area Hospitals. International Journal of Health Services, 39, 623-641. https://doi.org/10.2190/HS.39.4.b
Jedwab, R., Khan, A.M., Russ, J. and Zaveri, E.D. (2021) Epidemics, Pandemics, and Social Conflict: Lessons from the Past and Possible Scenarios for COVID-19. World Development, 147, Article ID: 105629. https://doi.org/10.1016/j.worlddev.2021.105629
Mohamed, K., Rzymski, P., Islam, M.S., Makuku, R., Mushtaq, A., Khan, A., et al. (2022) COVID-19 Vaccinations: The Unknowns, Challenges, and Hopes. Journal of Medical Virology, 94, 1336-1349. https://doi.org/10.1002/jmv.27487
Holt, E. (2021) COVID-19 Vaccination in Ukraine. The Lancet Infectious Diseases, 21, 462. https://doi.org/10.1016/S1473-3099(21)00156-0
Shishkin, A., Lhewa, P., Yang, C., Gankin, Y., Chowell, G., Norris, M., Skums, P. and Kirpich, A. (2023) Excess Mortality in Ukraine during the Course of COVID-19 Pandemic in 2020-2021. Scientific Reports, 13, Article No. 6917. https://doi.org/10.1038/s41598-023-33113-2
Chumachenko, D. and Chumachenko, T. (2022) Impact of War on the Dynamics of COVID-19 in Ukraine. BMJ Global Health, 7, e009173. https://doi.org/10.1136/bmjgh-2022-009173
Patwary, M.M., Browning, M.H.E.M. and Rodriguez-Morales, A.J. (2022) War in the Time of COVID-19 Crisis: A Public Health Emergency in Ukraine. Prehospital and Disaster Medicine, 37, 568-569. https://doi.org/10.1017/S1049023X22000863
Kovoor, J.G., Bacchi, S., Gupta, A.K. and Maddern, G.J. (2022) COVID-19 and the Ukraine-Russia Conflict: Warnings from History. British Journal of Surgery, 109, 777. https://doi.org/10.1093/bjs/znac133
Wentzensen, N., Clarke, M.A. and Perkins, R.B. (2021) Impact of COVID-19 on Cervical Cancer Screening: Challenges and Opportunities to Improving Resilience and Reduce Disparities. Preventive Medicine, 151, Article ID: 106596. https://doi.org/10.1016/j.ypmed.2021.106596
Uwishema, O., Sujanamulk, B., Abbass, M., Fawaz, R., Javed, A., Aboudib, K., et al. (2022) Russia-Ukraine Conflict and COVID-19: A Double Burden for Ukraine’s Healthcare System and a Concern for Global Citizens. Postgraduate Medical Journal, 98, 569-571. https://doi.org/10.1136/postgradmedj-2022-141895
Our World in Data (2023) Coronavirus Pandemic (COVID-19). https://ourworldindata.org/coronavirus#explore-the-global-situation
WHO. World Health Organization (2022) Dangerously Low Medical Oxygen Supplies in Ukraine Due to Crisis, WARN WHO Director-General and WHO Regional Director for Europe. https://www.who.int/news/item/27-02-2022-dangerously-low-medical-oxygen-supplies-in-ukraine-due-to-crisis-warn-who-director-general-and-who-regional-director-for-europe#
Zhdan, V.M., Holovanova, I.A., Khorosh, M.V., Bielikova, I.V. and Lyakhova, N.A. (2022) Analysis of the Legislative Activity of the Ministry of Health of Ukraine in the Conditions of the Russian-Ukrainian War in 2022. Wiadomosci Lekarskie, 75, 1425-1433. https://doi.org/10.36740/WLek202206101
WHO (World Health Organization) (2022) WHO Is Working Day and Night to Keep Medical Supply Chains Open and Preserve Ukraine’s Health System. https://www.euro.who.int/en/media-centre/sections/press-releases/2022/who-is-working-day-and-night-to-keep-medical-supply-chains-open-and-preserve-ukraines-health-system
WHO. World Health Organization (2023) Ukraine 1 Year on: This Is Not the Time to Let Fatigue Win. https://www.who.int/europe/news/item/17-02-2023-statement---ukraine-1-year-on--this-is-not-the-time-to-let-fatigue-win
UNHCR. United Nations High Commissioner for Refugees. Ukraine Refugee Situation. https://data.unhcr.org/en/situations/ukraine
Piotrowicz, K., Semeniv, S., Kupis, R., Rys, M., Perera, I., Gryglewska, B. and Gasowski, J. (2022) Disease Burden in Older Ukrainian Refugees of War: A Synthetic Reanalysis of Public Records Data. The Lancet Healthy Longevity, 3, e667-e673. https://doi.org/10.1016/S2666-7568(22)00187-8
Siddiqui, A., Abbas, S., Qamar, K., Islam, Z., Rahmat, Z.S., Essar, M.Y., et al. (2022) COVID-19 Vaccine Hesitancy in Conflict Zones: A Review of Current Literature. Frontiers in Public Health, 10, Article ID: 1006271. https://doi.org/10.3389/fpubh.2022.1006271
Mohamad, O., Zamlout, A., AlKhoury, N., Mazloum, A.A., Alsalkini, M. and Shaaban, R. (2021) Factors Associated with the Intention of Syrian Adult Population to Accept COVID19 Vaccination: A Cross-Sectional Study. BMC Public Health, 21, Article No. 1310. https://doi.org/10.1186/s12889-021-11361-z
Spiegel, P.B. and Khattar, C. (2017) Challenges and Recommendations for Providing Cancer Prevention and Treatment to Refugees in Lebanon and Jordan. 48th Middle East Medical Assembly: First Global Congress in Conflict Medicine, Lebanon, May 2017, 1-14.
Small, W., Bacon, M.A., Bajaj, A., Chuang, L.T., Fisher, B.J., Harkenrider, M.M., et al. (2017) Cervical Cancer: A Global Health Crisis. Cancer, 123, 2404-2412. https://doi.org/10.1002/cncr.30667
Van Hemelrijck, M., Fox, L., Beyer, K., Fedaraviciute, E., George, G., Hadi, H., et al. (2022) Cancer Care for Ukrainian Refugees: Strategic Impact Assessments in the Early Days of the Conflict. Journal of Cancer Policy, 34, Article ID: 100370. https://doi.org/10.1016/j.jcpo.2022.100370
UNISDR. United Nations Office for Disaster Risk Reduction. Sendai Framework for Disaster Risk Reduction 2015-2030. https://www.preventionweb.net/files/43291_sendaiframeworkfordrren.pdf
ACS American Cancer Society (2021) Coping with Cancer after a Natural Disaster: Frequently Asked Questions for People with Cancer and Their Caregivers. https://www.cancer.org/treatment/finding-and-paying-for-treatment/coping-with-cancer-after-a-natural-disaster.html
Voronenko, Y., Kolesnik, O., Mykhalchuk, V. and Kolesnyk, M. (2021) Awareness and Knowledge about Human Papillomavirus Infection and Vaccination among Ukrainian Women. Journal of Education, Health and Sport, 11, 531-539.
Ryzhov, A., Corbex, M., Pineros, M., Barchuk, A. andreasyan, D., Djanklich, S., et al. (2021) Comparison of Breast Cancer and Cervical Cancer Stage Distributions in Ten Newly Independent States of the Former Soviet Union: A Population-Based Study. The Lancet Oncology, 22, 361-369. https://doi.org/10.1016/S1470-2045(20)30674-4
Bonful, H.A., Addo-Lartey, A.A., Sefenu, R.S., Nwameme, A., Abagre, T.A., Awua, A.K., Adu-Aryee, N.A., et al. (2022) Developing a Culturally Tailored Short Message Service (SMS) Intervention for Improving the Uptake of Cervical Cancer Screening among Ghanaian Women in Urban Communities. BMC Women’s Health, 22, Article No. 154. https://doi.org/10.1186/s12905-022-01719-9
Reisinger, K.S., Block, S.L., Lazcano-Ponce, E., et al. (2007) Safety and Persistent Immunogenicity of a Quadrivalent Human Papillomavirus Types 6, 11, 16, 18 L1 Virus-Like Particle Vaccine in Preadolescents and Adolescents: A Randomized Controlled Trial. The Pediatric Infectious Disease Journal, 26, 201-209. https://doi.org/10.1097/01.inf.0000253970.29190.5a
Alemani, L., Saunier, M., et al. (2014) Human Papillomavirus DNA Prevalence and Type Distribution in Anal Carcinomas Worldwide. International Journal of Cancers, 136, 98-107. https://doi.org/10.1002/ijc.28963
Ganczak, M., Owsianka, B. and Korzeń, M. (2018) Factors That Predict Parental Willingness to Have Their Children Vaccinated against HPV in a Country with Low HPV Vaccination Coverage. International Journal of Environmental Research and Public Health, 15, Article No. 645. https://doi.org/10.3390/ijerph15040645
Doarn, C.R., Latifi, R., Poropatich, R.K., Sokolovich, N., Kosiak, D., Hostiuc, F., Zoicas, C., Buciu, A. and Arafat, R. (2018) Development and Validation of Telemedicine for Disaster Response: The North Atlantic Treaty Organization Multinational System. Telemedicine Journal and e-Health, 24, 657-668. https://doi.org/10.1089/tmj.2017.0237