Browsing by Author "Nygard, Mari"

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    Cervical Cancer in the Baltic States : Can Intelligent and Personalized Cancer Screening Change the Situation?
    (2022) Stankūnas, Mindaugas; Pärna, Kersti; Tisler, Anna; Ķīvīte-Urtāne, Anda; Kojalo, Una; Zodzika, Jana; Baltzer, Nicholas; Nygard, Jan; Nygard, Mari; Uuskula, Anneli; Institute of Public Health
    The three Baltic States (Estonia, Latvia, and Lithuania) are among the European Union countries with the highest incidence and mortality rates for cervical cancer. In order to tackle this public health challenge, there is an urgent need to implement more advanced and effective methods in cervical cancer prevention in Baltic countries. Nationwide cervical cancer screening programs in the Baltic States commenced in 2004-2009. While the organized screening programs in these countries differ in some relevant details (target age groups, screening interval), the underlying principles and problems, barriers are universal. However, the outcomes of present screening programs are unsatisfactory. In addition, universal screening programs are extremely costly. There is a potential need for more intelligent and personalized cervical cancer screening program. In 2019 the project "Towards elimination of cervical cancer: intelligent and personalized solutions for cancer screening" (2020-2023) was developed with the main objective - to develop improved and personalized cancer screening methods within a sustainable health care system. It is expected, that more sophisticated cervical cancer screening model will be implemented in Estonia, Latvia, and Lithuania, and will have a positive impact to epidemiology of cervical cancer and public health in general.
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    Comment on "The European response to the WHO call to eliminate cervical cancer as a public health problem"
    (2023-08-15) Tisler, Anna; Nygard, Mari; Kivite-Urtane, Anda; Berza, Natalija; Zodzika, Jana; Stankunas, Mindaugas; Baltzer, Nicholas; Pärna, Kersti; Uusküla, Anneli; Institute of Public Health
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    An overview of cervical cancer epidemiology and prevention in the Baltic States
    (2023-01) Kojalo, Una; Tisler, Anna; Parna, Kersti; Kivite-Urtane, Anda; Zodzika, Jana; Stankunas, Mindaugas; Baltzer, Nicholas; Nygard, Mari; Uuskula, Anneli; Institute of Public Health
    AIMS: To inform future Baltic States-specific policy analyses, we aimed to provide an overview of cervical cancer epidemiology and existing prevention efforts in Estonia, Latvia and Lithuania. METHODS: A structured desk review: we compiled and summarized data on current prevention strategies, population demography and epidemiology (high risk human papillomavirus (HPV) prevalence and cervical cancer incidence and mortality over time) for each Baltic State by reviewing published literature and official guidelines, performing registry-based analyses using secondary data and having discussions with experts in each country. RESULTS: We observed important similarities in the three Baltic States: high burden of the disease (high incidence and mortality of cervical cancer, changes in TNM (Classification of Malignant Tumors) stage distribution towards later stage at diagnosis), high burden of high-risk HPV in general population and suboptimal implementation of the preventive strategies as low screening and HPV vaccination coverage. CONCLUSIONS: Cervical cancer remains a substantial health problem in the region and the efforts in addressing barriers by implementing a four-step plan for elimination cervical cancer in Europe should be made. This goal is achievable through evidence-based steps in four key areas: vaccination, screening, treatment, and public awareness.
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    The prevalence of genital warts in the Baltic countries : Findings from national cross-sectional surveys in Estonia, Latvia and Lithuania
    (2015-02-01) Uusküla, Anneli; Reile, Rainer; Rezeberga, Dace; Karnite, Anda; Logminiene, Zeneta; Padaiga, Žilvinas; Nygard, Mari; Department of Obstetrics and Gynaecology; Department of Public Health and Epidemiology
    Objectives: To assess the prevalence and correlates of self-reported genital warts (GWs) among women and men aged 18-45 years in the Baltic countries. Methods: In 2011-2013 we performed a cross-sectional survey using a self-administered questionnaire to collect information on the history of clinically diagnosed GWs, sociodemographic characteristics and sexual behaviour. Probability sampling methods were used to invite 16 959 individuals representing the general population, of whom 7760 (45.8%) participated (Estonia: 1967 women, 1221 men; Latvia: 1525 women, 1525 men; Lithuania: 1522 women). Results: The estimated lifetime prevalence of clinically diagnosed GWs in women was 4.6% (95% CI 3.8 to 5.5) in Estonia, 2.9% (95% CI 2.0 to 3.6) in Latvia and 1.5% (95% CI 1.2 to 2.0) in Lithuania. Among men, the corresponding values were 2.8% (95% CI 1.9 to 4.0) in Estonia and 1.9% (95% CI 1.3 to 2.6) in Latvia. The mean age at first episode of clinically diagnosed GW was 24.6 years (95% CI 23.6 to 25.5) for women and 24.5 years (95% CI 22.9 to 26.0) for men. A lifetime history of clinically diagnosed GW was associated with a history of sexually transmitted infections other than GW (adjusted OR (AOR) 3.0, 95% CI 2.1 to 4.3 for women; AOR 5.3, 95% CI 3.0 to 9.2 for men), and a higher number (5+) of lifetime sexual partners (AOR 2.9, 95% CI 1.9 to 4.2 for women; AOR 2.1, 95% CI 1.2 to 3.9 for men). Men living comfortably within their household income had higher odds for GW (AOR 1.9, 95% CI 1.1 to 3.2). Conclusions: Our estimated prevalence of clinically diagnosed GWs was lower than estimates from the general population of other European countries.