in Albania - Instituti i Shendetit Publik

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ALBANIAN MEDICAL JOURNAL SUPPLEMENTPolicies and models adopted for breast and cervicalcancer screening in AlbaniaKozeta Filipi 1 , Alban Ylli 1,2 , Eduard Kakarriqi 1,2 , Philip Davis 31Department of Epidemiology and Health Systems, Institute of Public Health, Tirana, Albania;2Faculty of Public Health, University of Medicine, Tirana, Albania;3European Cervical Cancer Association.In Albania, there is no organized breast and cervixscreening program. More than half of cancer casesare diagnosed in the third or the fourth stage of thedisease. During the past five years, there has been asharp increase in the availability of mammographycenters, but the utilization rates remains low. Lastyear, a detailed analyses (supported by UNFPA)which provided precise recommendations onscreening techniques and organizational modelsappropriate for Albania was followed byintroduction of clinical breast examination (CBE)among performance indicators of primary healthcare (PHC) providers by the Institute of HealthInsurance.The analyses and assessments have concluded in thefollowing screening algorithms to be adopted inAlbania in the short to medium terms:i. Breast screening will be undertaken usingCBE provided by PHC providers with referral tothe secondary care level for mammography whenCBE abnormalities are detected. Mammographyabnormalities should be followed-up by biopsy atthe secondary care level with referral to tertiary carewhen cancer is suspected/diagnosed.ii. Cervical screening will be developed byusing the conventional Pap-test with cervical samplescollected and prepared by PHC providers forsubsequent delivery to the cytology laboratory.When Pap abnormalities are detected, womenshould be referred to secondary health care forcolposcopy and biopsy. Women with confirmedCIN should be treated by LEEP, etc. at thesecondary care level while those with suspected/diagnosed invasive cancer should be referred totertiary care.Further international collaboration would consist inproviding training opportunities on different levelsof screening system. Supporting participation ofAlbanian cancer specialists in forums and networks,where best practices are shared, is vital.Keywords:screening, breast cancer, cervical cancer, A lbania40 ALBANIAN MEDICAL JOURNAL SUPPLEMENT
INTERNATIONAL PUBLIC HEALTH CONFERENCE IN TIRANA, ALBANIAPsychosocial impact of oncologic palliative care inAlbaniaOrjola Pampuri 1 , Henrik Zotaj 21Institute of Public Health, Tirana, Albania;2Palliative Care Service Tirana, Albania.Treatment of individuals with cancer is a ratherchallenging endeavor in the Albanian context. Theinformation about palliative care is quite limited andcancer patients and their relatives are unfamiliar withthe necessary procedures and techniques of receivingpalliative care in Albania. The principles of servicedevelopment, methods and models of palliativecare are rapidly evolving in developed countries,though. Originally, palliative care was delivered inhospices where careful and ongoing efforts weremade to control pain at all time that patients weresuffering from various diseases, as well as controllingand stabilizing all the other symptoms, exhibited byindividuals.Currently, an important part of the treatment in thisregard pertains to the information with the latestdata on the number of patients and type of servicesoffered in oncology, palliative care specific centersin Tirana and, at the same time, the main goal is toprovide information about methods ofpsychotherapeutic treatment of patients receivingthese services, implementation and their effectiveness.The objectives of palliative care would be torecognize and inform the category of patientsreceiving medical treatment and psychotherapy, andevaluate the effectiveness of these services.Furthermore, the aim would be to inform andspecify the most effective psychotherapeutictreatments in oncology, palliative care as it affectspatients and their family members.For any kind of disease, no matter how advanced,regardless of treatment that can be given, there isalways something to obtain in terms ofimprovement of the quality of life of palliativepatients. The palliative care as a modern medicaldiscipline is relatively new, but it is one of the coredisciplines in the industrialized societies where agingissues are of paramount importance.Keywords: cancer, oncology, palliativecare,ALBANIAN MEDICAL JOURNAL SUPPLEMENT41
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