What is the role of the Cervical Screening Implementation Coordination Unit, and what concrete results has the National Screening Programme achieved in recent years?

The Cervical Screening Implementation Coordination Unit is a specialized structure within the Mother and Child Institute, responsible for coordinating the cervical screening programme at national level. Its main role is to ensure the uniform and effective implementation of cervical screening, to strengthen the capacities of the healthcare system, and to contribute to reducing the incidence of cervical cancer through early detection of precancerous lesions and early-stage cases.

In recent years, the National Screening Programme has recorded significant progress. Coverage with free cytological testing (Pap test) has steadily increased, from 36% in 2021 to 61% in 2024, reaching 62.15% in 2025. This growth reflects both expanded access to services and intensified public information and mobilization efforts.

According to official data, in 2024, 338 cases of cervical cancer were registered, of which 203 were detected through cytology and colposcopy, mostly at early stages, within the national screening programme implemented through primary healthcare. These results demonstrate the effectiveness of the procedure in early disease detection and in improving treatment outcomes.

Another important achievement is the development of the National Colposcopy Network, which currently includes 12 colposcopy units in 9 districts and in the municipalities of Bălți and Chișinău. This has significantly improved women’s access to specialized diagnostic services. At the same time, information campaigns have been organized at community level and at border crossing points, with the support of authorities and international partners, and the number of healthcare professionals trained in colposcopy, cytology, and gynecological histopathology has steadily increased.

What are the most effective methods for preventing cervical cancer, and what is the role of screening and HPV vaccination?

According to the World Health Organization, cervical cancer is one of the few cancers that can be almost entirely prevented and, in the long term, even eliminated through the consistent application of two essential measures: HPV vaccination as primary prevention and regular cervical screening as secondary prevention, combined with risk-reducing behaviors.

Persistent infection with the human papillomavirus (HPV), especially oncogenic types such as HPV 16 and 18, is the main cause of cervical cancer. HPV vaccination significantly reduces the risk of infection with these virus types and, consequently, the risk of developing precancerous lesions and cervical cancer. Vaccine effectiveness is highest when administered before the onset of sexual activity, but benefits are also maintained in sexually active adolescents and young adults.

In the Republic of Moldova, HPV vaccination is included in the National Immunization Programme for 2023–2027 and is provided free of charge nationwide to adolescents—girls and boys—aged 9 to 14, and to women up to and including 26 years of age. In addition, this year, the National Agency for Public Health is conducting a catch-up HPV vaccination campaign. Individuals over the age of 26 who have not been vaccinated are encouraged to consult their family doctor for information and appointment scheduling.

Cervical screening plays a crucial role in detecting precancerous lesions or early-stage cervical cancer, when treatment is most effective and cure rates are very high.

Screening methods include the Pap test, which identifies abnormal cellular changes; the HPV test, which detects oncogenic virus types; and co-testing, which combines both methods. By identifying and treating precancerous lesions in time, screening significantly contributes to reducing cervical cancer mortality.

HPV vaccination prevents the infection that underlies cervical cancer development, while cervical screening enables early detection of treatable cellular changes. Together, these interventions can reduce the risk of cervical cancer by more than 90%. When prevention measures are applied correctly and consistently, cervical cancer becomes one of the most preventable forms of cancer.

Who is eligible for cervical screening in the Republic of Moldova, and how can women access free services?

In the Republic of Moldova, cervical screening is intended for all women aged 25 to 61, regardless of their health insurance status. These services are available to women who are citizens of the Republic of Moldova, as well as to those holding residence permits and officially registered, including refugees from Ukraine.

Screening is performed once every three years, and the test is free of charge.

To access screening, women should consult their family doctor, who will schedule the appointment and explain the necessary steps. The family doctor is the first point of access to the programme.

There are also special cases. Women with immunodeficiency, such as those living with HIV or those who have undergone organ transplantation, should undergo screening annually, as their risk is higher.

Through this programme, the state provides free access to essential investigations aimed at early detection of changes that may lead to cervical cancer and ensuring timely treatment.

What are the main obstacles to increasing participation in cervical screening, and what solutions exist?

One of the main obstacles is internal and external migration. Many women live temporarily or permanently in other localities or abroad, which makes regular access to their registered family doctor more difficult.

To address this issue, the creation of national sample collection points is being considered, where women could access screening regardless of their registered family doctor. This would make services more accessible and flexible.

Another important recently implemented measure is the electronic invitation system. Eligible women receive email notifications informing them that it is time for screening. These invitations are automatically generated by the screening registry, a module of the family doctor’s information system, based on women’s age and population registry data.

Public awareness also plays a crucial role. Media campaigns and communication activities explain the importance of disease prevention, especially cervical cancer, and the benefits of free screening. These efforts contribute to increased awareness and encourage active participation in prevention programmes.

Through these measures, authorities aim to reduce access barriers and increase the number of women benefiting from this procedure.

What message do you have for women who have not yet participated in screening, and why is it important to take this opportunity even without symptoms?

We are fortunate to live in the 21st century, when science knows how to prevent cervical cancer, and when Moldova’s healthcare system provides universal access to screening and vaccination services for all eligible women. Simply visit your family doctor and exercise your right to health.

Cervical cancer can be eliminated from the lives of women in the 21st century. Have courage!