Cervical cancer in the Maghreb country (Morocco - Algeria - Tunisia) : epidemiological, clinical profile and control policy

Abstract

Introduction: Cervical cancer is a public health problem in the Maghreb countries with high mortality and socio-economic impact. The objective of this subject is exposed the epidemiological profile, programs of prevention and the support of cervical cancer in Maghreb (Morocco, Tunisia and Algeria).

Methods: To implement this work, we carried out research on morbidity and mortality; cancer plans for Maghreb countries (Morocco, Algeria and Tunisia); cervical cancer surveillance for each country; the prevention programs of cervical cancer including vaccination, screening, information campaigns, awareness and education; and research conducted in Morocco, Algeria and Tunisia. We interviewed databases (Pubmed, Sciences Direct etc.), ministerial website, World Health Organization website, foundations website and centers of cancer research.

Results: The cervical cancer (CC) is diagnosed at advanced stages. The majority of patients are in advanced stages (stage II, III and IV). Regarding the histological profile squamous cell carcinoma is predominant. HPV 16 and HPV 18 single or multiple infection are by far the most common types of HPV associated with CCU in the Maghreb countries concerning the microbiological profile. All three countries have set up a cancer plans to prevent and control this disease and these impacts. Among the strong points of health policy in cancerology, in all three countries, we raised the existence of a cancer registry for monitoring and evolution of disease. Regarding the prevention of CC, in the three Maghreb countries, there is no primary prevention program (HPV vaccine and the struggle against risk factors), much deficiencies about secondary and tertiary prevention.

Conclusion: To win the fight against the CC, the Maghreb countries are called to strengthen the health system globally, to consolidate the national policy and the national guidelines to fight against the CC and to allocate the financial and technical resources to support the implementation policy and guidelines to make services accessible and affordable for women and girls.