HPV Vaccination and Cervical Cancer Screening Policies and Practices in 18 Countries, Territories and Entities across Eastern Europe and Central Asia

Davies P. Aluloski I. Arifdjanova D. Brcanski J. Davidzenka A. Durdyeva A. Umarzoda S.G. Goshliyev K. Jovanović V. Jugeli L. Kocinaj-Berisha M. Maistruk G. Naumović T. Pilav A. Rzayeva G. Saribekyan K. Siljak S. Ten E. Valuta D. Veljković M. Yildirimkaya G. Ylli A. Zhylkaidarova A. Melnic E.
2023 Asian Pacific Organization for Cancer Prevention

Asian Pacific Journal of Cancer Prevention
2023 #24 Issue 5 1781 - 1788 pp.

Background: To assess readiness to achieve the WHO Global Strategy targets for HPV vaccination and cervical screening and to guide capacity building, the current status of these services in 18 Eastern European and Central Asian countries, territories and entities (CTEs) was evaluated. Methods: In order to assess the current status of HPV vaccination and cervical cancer screening in these 18 CTEs, a 30 question survey tool was developed, covering: national policies, strategies and plans for cervical cancer prevention; status of cancer registration; status of HPV vaccination; and current practices for cervical cancer screening and treatment of precancerous lesions. As cervical cancer prevention comes within the mandate of the United Nations Fund for Population Development (UNFPA), the UNFPA offices in the 18 CTEs have regular contact with national experts who are directly involved in cervical cancer prevention actions and are well placed to provide the data required for this survey. Working through the UNFPA offices, the questionnaires were sent to these national experts in April 2021, with data collected from April to July 2021. All CTEs returned completed questionnaires. Results: Only Armenia, Georgia, Moldova, North Macedonia, Turkmenistan and Uzbekistan have implemented national HPV vaccination programmes, with only the last 2 of these reaching the WHO target of 90% of girls fully vaccinated by age 15, while rates in the other 4 range from 8%-40%. Cervical screening is available in all CTEs but only Belarus and Turkmenistan have reached the WHO target of 70% of women screened once by age 35 and again by age 45, while rates elsewhere range from 2%-66%. Only Albania and Turkey follow the WHO recommendation to use a high-performance screening test, while the majority use cervical cytology as the main screening test and Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan use visual inspection. No CTEs currently operate systems to coordinate, monitor and quality assure (QA) the entire cervical screening process. Conclusions: Cervical cancer prevention services in this region are very limited. Achieving the WHO Global Strategy targets by 2030 will require substantial investments in capacity building by international development organisations.

capacity building , Central Asia , cervical screening , Eastern Europe , HPV vaccination

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Department of Pathology, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, Moldova
University Clinic for Obstetrics and Gynecology, Medical Faculty, University “Sveti Kiril i Metodij”, North Macedonia
Ministry of Health of the Republic of Uzbekistan, Tashkent, Uzbekistan
Center for Analysis, Planning and Organization of Health Care, Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Serbia
UNFPA Country Office, Minsk, Belarus
Reproductive Health Center, Center for Maternal and Child Health, Ashgabat, Turkmenistan
Ministry of Health and Social Protection of the Population of the Republic of Tajikistan, Dushanbe, Tajikistan
UNFPA Country Office, Ashgabat, Turkmenistan
Black Sea Coalition for Breast and Cervical Cancer Prevention, Tbilisi, Georgia
Department for Social Medicine, National Institute of Public Health and Medical Faculty, University of Prishtina, Pristina, Serbia
Charity Foundation “Women’s Health and Family Planning”, Kiev, Ukraine
Health Institute of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina
Department of Ambulatory and Diagnostic Services, Scientific Research Institute of Obstetrics and Gynecology, Baku, Azerbaijan
National Institute of Health, Ministry of Health, Yerevan, Armenia
Public Health Institute of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
Sector of Medico-Social Investigations, Scientific Centre of Preventive Medicine, Bishkek, Kyrgyzstan
Cervical Screening Coordination Unit, Institute of Mother and Child, Chisinau, Moldova
UNFPA Country Office, Ankara, Turkey
Department of Public Health & Non Communicable Diseases, Institute of Public Health, Tirana, Albania
Specialized Consultative and Diagnostic Department, Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan

Department of Pathology
University Clinic for Obstetrics and Gynecology
Ministry of Health of the Republic of Uzbekistan
Center for Analysis
UNFPA Country Office
Reproductive Health Center
Ministry of Health and Social Protection of the Population of the Republic of Tajikistan
UNFPA Country Office
Black Sea Coalition for Breast and Cervical Cancer Prevention
Department for Social Medicine
Charity Foundation “Women’s Health and Family Planning”
Health Institute of Canton Sarajevo
Department of Ambulatory and Diagnostic Services
National Institute of Health
Public Health Institute of the Republic of Srpska
Sector of Medico-Social Investigations
Cervical Screening Coordination Unit
UNFPA Country Office
Department of Public Health & Non Communicable Diseases
Specialized Consultative and Diagnostic Department

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