Cervical cancer is the fourth most common cancer among women worldwide with close to 660,000 new cases and approximately 350,000 deaths in 2022.
In the Federation of Bosnia and Herzegovina, the incidence rate of this type of malignant disease shows a growing trend (per 10,000 women in 2013 it was 3.6, and in 2023 it was 5.2), as well as the death rate (per 100,000 women in 2013 it was 4.2, and in 2023 it was 7.1), according to the data of the Institute for Public Health of the FBiH.
The public institution Institute for the Protection of Women and Maternity of Sarajevo Canton is on the front line of women’s health care.
They are stationed in eight localities and are available to all women in the canton.
More than 22,700 Pap tests performed
An interesting fact is that this Institute provided more than 270,000 health services in 2025 alone, and more than 22,700 Pap tests were performed.
Mr. sci. Ph.D. Vanesa Dujso, specialist in gynecology and obstetrics and director of the Institute, says that certainly no health institution in Bosnia and Herzegovina has performed more Pap tests.
– We are actively working on preventive examinations for cervical cancer, but last year we had 1,700 positive Pap tests. Of course, this does not mean that they were all cancers, but the test revealed changes that were forwarded to further diagnostics – HPV typing, colposcopy, biopsy… As a representative of an institution that is focused on the protection of women’s health and maternity, I have the obligation to point out the importance of regular gynecological examinations – Dujso points out on the occasion of the European Cervical Cancer Prevention Week.
He emphasizes that the data indicate that cervical cancer in Bosnia and Herzegovina is one of the most common malignant diseases in women. It is the third most common, right after breast and lung cancer.
– These are devastating data if we take into account developed countries where this disease is much less common. It most often occurs between the ages of 35 and 50. The incidence in developed countries is decreasing every year precisely because of regular screening programs and better quality treatment. Every woman should understand the importance of regularly going to the gynecologist at least once a year for a preventive examination with an ultrasound and a Pap test – adds Dujso.
The main cause of cervical cancer is the human papillomavirus (HPV). That is why, according to our interlocutor, it can be said that it is almost the only cancer for which its pathophysiology is reliably known.
– Of course, apart from HPV, there are other causes of the disease such as smoking, immunodeficiency, sexually transmitted diseases, early sexual intercourse, unprotected sex, positive family history… – explains Dujso.
Under the veil of stigma and misogyny
She emphasizes that women in Bosnia and Herzegovina still hesitate to go to a gynecologist, especially those who live in more rural areas, and that women who are ill are still under the veil of stigma and misogyny.
– There is no reason to dissuade a woman from a gynecological examination. It is completely safe, painless and most importantly it can save her life. Pap test is simple, available to everyone and effective. Cervical cancer can be prevented, and if detected at an early stage, it is completely curable. Every woman should know this and do everything to go for an examination at least once a year even when she does not feel any symptoms. I must boast that we have a large number of patients who regularly come for examinations, but there is also a group of women who do not come. They are our focus – how to educate them and persuade them to come for an examination and devote themselves to their health, because when symptoms appear, it is quite late – Dujso points out.
As of 2023, six HPV vaccines are available worldwide. They all protect against high-risk HPV types 16 and 18, which cause most cervical cancers.
They have been shown to be safe and effective in preventing HPV infection and cervical cancer.
As a priority, HPV vaccines should be given to all girls between the ages of nine and 14, before they become sexually active. The vaccine can be administered in one or two doses.
People with compromised immune systems should receive two or three doses.
Some countries have also decided to vaccinate boys to further reduce the prevalence of HPV in the community and prevent male cancers caused by HPV, it says Factor.
The health authorities in Sarajevo Canton provided HPV vaccines initially for girls and boys aged 11 to 14, and later the immunization was extended to the age of 26.
– The goal of HPV vaccination is to prevent infection. The vaccine is free, safe and reliable. After the campaign that was conducted in the last few months in public, in schools where we educated both students and their parents, I can say that the response to vaccination has increased, which is really good information – said Dujso.
