Article · PubMed · March 1, 2025

EXPERIENCE OF IMPLEMENTING DIGITAL TELEMEDICINE TECHNOLOGIES TO IMPROVE ACCESS TO CERVICAL CANCER SCREENING IN RURAL AREAS OF THE REPUBLIC OF KAZAKHSTAN.

A B Utegenova, Gulzhaina Kuralbayevna Kassymova, Ildar Ravisovich Fakhradiyev

Abstract

INTRODUCTION: Cervical cancer (CC) remains one of the leading causes of cancer-related mortality among women in Kazakhstan, particularly in rural areas where access to preventive measures is limited. The aim of this study was to assess the effectiveness of a digital screening model for CC implemented in rural settings, compared to standard practice. MATERIALS AND METHODS: The study was conducted in Almaty region from 2018 to 2024 using a mixed design: a retrospective analysis of data on screening coverage, detection rates, and patient routing (2018-2022), and a cluster-randomized prospective study (2023-2024) with the implementation of digital solutions. In the intervention group, telemedicine, electronic registries, and an SMS notification system were implemented. The primary indicators included screening coverage, detection of pathologies, patient follow-up, and satisfaction measured using the PSQ-18 scale. RESULTS: In the intervention group, screening coverage reached 94.0% in urban and 90.0% in rural areas, compared to 92.0% and 88.0% respectively in the control group (p<0.001). The detection rate of pathological changes was 15.0% in urban and 12.0% in rural areas in the intervention group, versus 13.0% and 10.0% in the control group (p<0.001). The proportion of patients enrolled in follow-up among those with detected abnormalities was also higher in the intervention group: 75.0% in urban and 60.0% in rural areas, compared to 55.0% and 40.0% in the control group (p=0.0016 and p=0.0011, respectively). Satisfaction scores on the PSQ-18 scale were significantly higher in the intervention group in the following domains: technical quality (4.5±0.4 vs 3.9±0.7; p=0.001), accessibility (4.5±0.3 vs 3.7±0.2; p=0.001), and financial aspect (4.4±0.4 vs 4.0±0.7; p=0.023). CONCLUSION: The digital model for CC screening has proven effective in settings with limited access to healthcare. The results support scaling up this model within the national oncology strategy and contribute to achieving the global cervical cancer elimination targets.

Telemedicine and Telehealth ImplementationWomen's cancer prevention and managementCervical Cancer and HPV Researchcervical cancer screeningtelemedicinedigital health

EXPERIENCE OF IMPLEMENTING DIGITAL TELEMEDICINE TECHNOLOGIES TO IMPROVE ACCESS TO CERVICAL CANCER SCREENING IN RURAL AREAS OF THE REPUBLIC OF KAZAKHSTAN.

Abstract

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