DYNAMICS OF SPECIAL SCREENING EXAMINATION FOR CERVICAL NEOPLASMS IN UKRAINE: ANALYSIS OF DATA AND DISPARITIES FOR 2020–2025

Abstract

Relevance. Cervical dysplasia (cervical intraepithelial neoplasia CIN) is a precancerous condition, the timely detection of which is crucial for the prevention of cervical cancer. Given the high rates of morbidity and mortality from this pathology in Ukraine, an important area of public health policy is the implementation of an effective population screening system. Timely diagnosis of dysplasia helps to avoid its transition to malignancy and preserve a woman's repro- ductive health. The relevance of the study is due to the need to assess the screening coverage of the female population of Ukraine, identify organizational barriers, and develop scientifically based proposals to improve the effectiveness of preventive work.Objective. To analyze the coverage of the female population of Ukraine with cervical screening examinations according to code Z12.4 in 2020-2025 by age groups and regions, to identify the main trends and factors of influence, and to suggest ways to improve the organization of population screening for cervical dysplasia.Materials and methods. The study used statistical data from the National Health Service of Ukraine on the number of women screened for cervical neoplasms (code Z12.4) for the periods: 2020 (II-IV quarters), 2021, 2022, 2023, 2024, and the first quarter of 2025. The data is structured by 26 administrative-territorial units (25 oblasts and the city of Kyiv) and three age groups: 18-39 years, 40-64 years, 65+ years. Methods of descriptive statistics, analysis of dynamics, comparative assessment, coefficients of variation, and calculation of intergroup correlations were used.Results. During the study period, 108,230 women were screened. The highest coverage rate was observed in the 40-64 age group 51,607 women (47.7%), which is in line with international recommendations for the target cohort. In the 18-39 age group, 43,608 women (40.3%) were screened, and in the 65+ group, 13,015 women (12.0%). Peak coverage occurred in 2023 (34,690 examinations). The most active regions were Kyiv city, Lviv and Odesa regions, while the lowest rates were recorded in Donetsk, Kirovohrad and Luhansk regions. There was a high positive correlation between screening volumes in the 18-39 and 40-64 age groups (r = 0.87), indicating a systematic approach in some regions. At the same time, the 65+ category demonstrates low coverage and significant variability between regions.Conclusions. Cervical dysplasia screening in Ukraine in 2020-2025 shows positive dynamics with a gradual expansion of coverage. The screening system works most effectively in regions with developed primary care infrastructure, intersectoral cooperation, and digital record-keeping tools. At the same time, the problems of low coverage of older women, significant regional disparities, and insufficient sustainability of the dynamics after 2023 remain. To improve the effectiveness of screening, it is recommended to: introduce a unified electronic register of preventive examinations; expand mobile screening programs for hard-to-reach groups; provide motivation and information to women through family doctors; update screening standards with psychoeducational components; to implement a regulatory framework for the role of primary care in the screening process.The comprehensive implementation of these measures will improve the quality, accessibility and effectiveness of early detection of cervical dysplasia, which is key to reducing the cancer burden on the female population of Ukraine.