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dc.contributor.authorPatumrat Sripanen_US
dc.contributor.authorImjai Chitapanaruxen_US
dc.contributor.authorMiranda M. Fidler-Benaoudiaen_US
dc.contributor.authorAdalberto Miranda-Filhoen_US
dc.contributor.authorAude Bardoten_US
dc.contributor.authorDonsuk Pongnikornen_US
dc.contributor.authorPuttachart Maneesaien_US
dc.contributor.authorNarate Waisrien_US
dc.contributor.authorChirapong Hanpragopsuken_US
dc.contributor.authorEkkasit Tharavichitkulen_US
dc.contributor.authorIsabelle Soerjomataramen_US
dc.description.abstract© 2019 Elsevier Ltd Universal Health Coverage (UHC) was implemented in Thailand in 2002. This study aims to compare cervical cancer incidence and survival before and after the implementation of UHC, including the national screening program, in the Chiang Mai population in Northern Thailand. Data of women diagnosed with in situ or malignant cervical cancer in Chiang Mai during 1998–2012 were used in our analysis. Annual age-standardized incidence rates (ASR) and age-adjusted relative survival (RS) were estimated for the following three diagnosis periods: period I: 1998–2002 (before UHC), period II: 2003–2007 (UHC implementation) and period III: 2008–2012 (after UHC). The ASR peaked in 2001 at 38 per 100,000, and then subsequently declined to 23 per 100,000 in 2012. The proportion of in situ and localized tumors increased in all age groups, while regional tumors declined. In all women (aged 15–89) with malignant cervical cancer or in situ, the 5-year RS in Period I, Period II and Period III was 73%, 74% and 77%, respectively; when only malignant cases were considered, the RS was 63%, 61% and 62%, respectively. In the screening target women (aged 30–59) with malignant or in situ tumors, the 5-year RS was 84%, 88% and 90%, respectively, in the three periods, while the RS was 71%, 74% and 75%, respectively, in only those with malignant cancers. The introduction of UHC including national cervical cancer screening program has likely reduced the magnitude and severity of cervical cancer and improved the survival of cervical cancer in the screening target age group.en_US
dc.subjectBiochemistry, Genetics and Molecular Biologyen_US
dc.titleImpact of universal health care and screening on incidence and survival of Thai women with cervical cancer: A population-based study of the Chiang Mai Provinceen_US
article.title.sourcetitleCancer Epidemiologyen_US
article.volume63en_US Health Servicesen_US Agency for Research on Canceren_US Mai Universityen_US Cancer Hospitalen_US
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