Slovakia has long had poor outcomes for breast and cervical cancer, mainly due to low participation in screening. New legislation aims to replace "opportunistic" examinations with an organized program with clear intervals and rules. Experts welcome the move but point out gaps in accessibility, women's motivation, and continuous communication.
Why we lag behind: low participation and poor awareness
In Slovakia, approximately 600 new cases of cervical cancer are added each year, and about 200 of them affect women under 40. The number of breast cancer cases has risen from roughly 1,800–2,000 per year to about 3,500, which is also related to broader detection thanks to screening. However, women's participation remains low: for cervical cancer around 35–40%, similarly for mammography. Only about 20% of women accepted invitations for examination for mammography and roughly 10% for cytology, which significantly undermines the benefit of the whole system.
What is changing: organized screening and clear intervals
Preventive check-ups are moving closer to the practice of Western countries: breast ultrasonography is dropping out of routine, with greater emphasis on clinical (palpation) examination. For the cervix, liquid-based cytology every three years is introduced from ages 23 to 34, and HPV testing at five-year intervals from ages 35 to 64. For the breast, mammography is to be performed from ages 45 to 69 every two years, and after age seventy every three years. If a woman has symptoms or the gynecologist finds a suspicious finding, targeted testing is indicated (e.g., ultrasound, cytology, or HPV test), with the aim of the new rules also to limit unnecessary and costly repeat testing without a clear indication.
Accessibility, quality, and motivation: where to push further
The new rules count only on screening mammography facilities and on additional certification for radiologists and technicians. The set volume criteria (e.g., thousands of mammograms read per physician and high annual output per facility) are meant to safeguard quality, but at the same time may reduce geographic accessibility; in practice, women from some larger cities travel tens of kilometers for an examination. Experts are calling for adjustments to the process so that it is possible to train properly and bring new centers on board without the "vicious circle" of required volumes. Continuous education and personal invitations via gynecologists will also be key, as will motivation through health insurer benefits and instilling prevention from childhood; encouragingly, the HPV vaccination rate has risen from roughly 5% to 30–40%, with the aim to achieve substantially higher coverage.
