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

Document Type : Research Articles


1 Department of Pathology, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, Republic of Moldova.

2 University Clinic for Obstetrics and Gynecology, Medical Faculty, University “Sveti Kiril i Metodij”, North Macedonia, Republic of Moldova.

3 Ministry of Health of the Republic of Uzbekistan, Tashkent, Uzbekistan.

4 Center for Analysis, Planning and Organization of Health Care, Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Serbia.

5 UNFPA Country Office, Minsk, Belarus.

6 Reproductive Health Center, Center for Maternal and Child Health, Ashgabat, Turkmenistan.

7 Ministry of Health and Social Protection of the Population of the Republic of Tajikistan, Dushanbe, Tajikistan.

8 UNFPA Country Office, Ashgabat, Turkmenistan.

9 Black Sea Coalition for Breast and Cervical Cancer Prevention, Tbilisi, Georgia.

10 Department for Social Medicine, National Institute of Public Health, and Medical Faculty, University of Prishtina, Pristina, Kosovo.

11 Charity Foundation “Women’s Health and Family Planning”, Kiev, Ukraine.

12 Health Institute of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina.

13 Department of Ambulatory and Diagnostic Services, Scientific Research Institute of Obstetrics and Gynecology, Baku, Azerbaijan.

14 National Institute of Health, Ministry of Health, Yerevan, Armenia.

15 Public Health Institute of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina.

16 Sector of Medico-Social Investigations, Scientific Centre of Preventive Medicine, Bishkek, Kyrgyzstan.

17 Cervical Screening Coordination Unit, Institute of Mother and Child, Chisinau, Republic of Moldova.

18 UNFPA Country Office, Ankara, Turkey.

19 Department of Public Health & Non Communicable Diseases, Institute of Public Health, Tirana, Albania.

20 Specialized Consultative and Diagnostic Department, Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan.


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.


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