Frequently Asked Questions
Cervical cancer:
Where can I get additional information and medical help?
Official information can be obtained from:
- Ministry of Health of the Republic of Moldova (MHMPS)
- National Agency for Public Health (ANSP)
- Mother and Child Institute (IMC)
For testing and consultations, women can contact their family doctor or gynecologist at the medical institution where they are registered.
Is monitoring necessary after treatment?
Yes. Women treated for precancerous lesions or cervical cancer should have regular medical check-ups, as recommended by their gynecologist or oncologist. Post-treatment monitoring is an important part of the recovery process.
Is cervical cancer genetically inherited?
Cervical cancer is not considered a hereditary disease. The main cause is persistent infection with the HPV virus, not genetic transmission.
Is healing possible?
Yes. If detected early, cervical cancer can be treated successfully.
Participating in periodic cytological screening allows for early detection and increases the chances of complete cure.
How is cervical cancer treated?
Treatment depends on the stage of the disease and is performed exclusively in specialized oncological institutions, according to protocols approved by the Ministry of Health.
Treatment may include:- removal of the affected area (in early lesions)
- surgical interventions
- radiotherapy or chemotherapy (in advanced stages)
The type of treatment is determined by the oncologist based on the results of the investigations.
What are the possible symptoms of cervical cancer?
In its early stages, the disease usually causes no symptoms. As it progresses, the following may occur:
- abnormal vaginal bleeding, including after sexual intercourse
- unusual vaginal discharge
- persistent pelvic discomfort or pain
The appearance of these symptoms does not necessarily mean cancer, but requires a medical consultation.
What are the main risk factors?
- persistent infection with oncogenic HPV types (especially 16 and 18)
- early onset of sexual life
- multiple sexual partners
- smoking
- weakened immune system
- lack of regular cytology testing
What are precancerous lesions?
Precancerous lesions, called cervical intraepithelial neoplasia (CIN), are changes in the cells of the cervix that can precede the development of cancer. They can be effectively treated if discovered early through screening and colposcopy.
How does cervical cancer occur?
HPV infection is common, but the body usually clears it on its own. In some cases, the virus persists and causes changes in the cells of the cervix. If these changes are not detected and treated in time, they can develop into cervical cancer over time.
What is cervical cancer?
Cervical cancer is a condition in which the cells in the cervix undergo persistent changes and form a malignant tumor. In most cases, the main cause is long-term infection with certain types of human papillomavirus (HPV), especially types 16 and 18.
Cervical screening:
What do I do if I take the test at another medical institution?
If the test is performed in another medical institution, the woman must present the result to her family doctor for inclusion in the medical record.
Do I have to sign a consent form for the test?
Yes. Before the test is performed, the woman signs the informed consent form in duplicate, according to Annex 3 of the Standard for the Organization and Operation of the Cervical Screening Service. One copy remains with the woman, and the other with the medical institution.
What happens to my data and sample after the test?
Personal data are processed in accordance with Law No. 133/2011 on the protection of personal data. Cytological sample slides are kept in the laboratory for a minimum of 5 years, under appropriate conditions, according to the archiving rules of the National Cervical Screening Program.
What do I do if I have a vaginal infection or menstruation on the day of the test?
The test is rescheduled by medical personnel after the infection is treated or after menstruation ends.
What happens if the result is abnormal?
The result is analyzed by the gynecologist, who determines the next medical steps according to the management algorithm provided in the Standard for the organization and operation of the cervical screening service.
What do the terms ASC-US, LSIL, HSIL, and AGC mean?
These terms are used in the cytology report and describe the type of cell changes. The gynecologist determines, according to the Standard approved by the Ministry of Health, whether colposcopy, repeat test or other investigation is necessary.
How is the result of the cytology test formulated?
The result can be:
- normal – no cellular changes were identified;
- abnormal – changes have been observed that require further investigation;
- unsatisfactory – the sample could not be evaluated and the test must be repeated.
How and when are the test results released?
The test result is issued by the laboratory within 30 calendar days from the date of collection. The family doctor informs the woman about the result.
How long does the procedure take?
The procedure takes a few minutes and does not require anesthesia.
How should I prepare for the test?
The test is not performed during menstruation. Avoid sexual intercourse for the last 24 hours and the use of vaginal douches or ovules for the last 48 hours before collection.
Colposcopy:
How are colposcopy data and results stored?
Medical data are managed confidentially, in accordance with Law No. 133/2011 on the protection of personal data. The results are archived in the medical institution for the period provided for by the medical archiving regulations.
What happens if the colposcopy result shows lesions?
If the presence of lesions is confirmed, the gynecologist establishes the treatment plan according to the management algorithm provided in the Standard for the organization and operation of the cervical screening service.
If I am sent for a colposcopy, does that mean I have cancer?
No. Colposcopy is not a cancer diagnostic procedure, but an investigation to clarify cellular changes observed in the cytological test.
What happens to the biopsy result, if it was performed?
The sample taken is analyzed in the histopathology laboratory. The biopsy result is usually issued within 30 calendar days, depending on the laboratory’s workload, and is interpreted by the gynecologist.
What happens after colposcopy?
After colposcopy, the woman can resume her daily activities. If a biopsy was performed, it is recommended that she avoid sexual intercourse, hot baths, and the use of vaginal tampons for 2–3 days.
Is colposcopy painful?
Colposcopy is not painful. The application of the solutions may cause a slight burning sensation or transient discomfort.
How long does the procedure take?
The procedure usually takes between 10 and 20 minutes.
What happens during colposcopy?
The doctor examines the cervix using a colposcope and applies special solutions – 3–5% acetic acid and Lugol’s solution – to highlight areas of possible changes. If necessary, a tissue sample (biopsy) may be taken for microscopic examination.
How should I prepare for colposcopy?
Colposcopy is not performed during menstruation. Sexual intercourse is avoided for 24 hours and the use of douches or vaginal washes for 48 hours before the examination.
Are there situations when colposcopy is postponed?
Yes. The procedure is postponed in case of acute vaginal infections, heavy bleeding or recent interventions on the cervix, until complete healing.
HPV Vaccination:
Is vaccination mandatory?
No. HPV vaccination is voluntary, but recommended by Ministry of Health as part of cervical cancer prevention measures.
Can the vaccine be administered during pregnancy?
No. Vaccination is postponed until after the end of pregnancy.
Why is HPV vaccination important?
HPV vaccination is a primary prevention measure which prevents infection with HPV types associated with cervical cancer. It is a safe and effective method of prevention recommended by Ministry of Health.
Is the vaccine safe?
Yes. The vaccine has been used worldwide for over 15 years. In the Republic of Moldova, HPV vaccination has been carried out since 2017, and to date over 50,000 girls have been vaccinated. Only mild reactions have been reported, with no confirmed severe cases.
Is parental consent required?
Yes. Vaccination of children is carried out only after signing the informed consent by one of the parents or the legal representative.
Where and how is vaccination carried out?
Vaccination is carried out in public medical institutions, by the family doctor or nurse. It is free of charge, being included in the National Vaccination Calendar. Each batch of vaccine is delivered and stored under controlled conditions, under the supervision of National Agency for Public Health (ANSP).
How many doses are needed and at what interval are they administered?
- Children aged 9-14 receive one dose of the vaccine. Young people aged 14-26 receive two doses 6 months apart.
- The current scheme in the National Program is based on WHO recommendations and may be updated based on new scientific evidence.
Who can be vaccinated?
Vaccination is recommended and offered free of charge to girls and boys aged between 9 and 14 years old, according to National Immunization Program and National Vaccination Calendar.
How is HPV transmitted and why is it common?
HPV is mainly transmitted through sexual contact. Most sexually active people can come into contact with the virus, even if they do not have symptoms. Therefore, vaccination before the start of sexual activity offers the best protection.
What is HPV?
HPV means human papillomavirus. It is a group of viruses that can infect the skin and mucous membranes. Some types of HPV can cause lesions that, if left untreated, can lead to cervical cancer.
Myths and clarifications about HPV vaccination:
Why do some countries use other HPV vaccines?
Each country selects the vaccine based on approved licenses and international availability. In the Republic of Moldova, the Gardasil-4 vaccine is approved and used, according to the National Immunization Program.
Does vaccination make sense even before the onset of sexual life?
Yes. Vaccination is most effective when administered before exposure to the virus, that is, before the onset of sexual activity.
Is the vaccine a new and untested method?
No. The vaccine has been used globally for over 15 years, being approved by the World Health Organization and included in immunization programs in over 100 countries.
Does the vaccine provide complete protection?
Gardasil – 4 is a tetravalent vaccine, protecting against strains 6,11,16,18, responsible for most cases of cervical cancer, but not against all types. Therefore, regular screening remains important.
If I am over 14 years old, can I still be vaccinated?
Children aged 9-14 receive one dose of the vaccine. Young people aged 14-26 receive two doses 6 months apart.
Does the vaccine cause serious side effects?
Serious side effects are very rare. Mild reactions at the injection site – pain, redness or swelling – may occur, which disappear within a few days.
Does the vaccine contain active virus?
No. The vaccine does not contain live virus. It only contains particles that mimic the structure of the virus and help the body develop immunity.
If I am vaccinated, do I still need to have a Pap test?
Yes. Vaccination does not replace screening. Cytological testing remains necessary to detect other types of HPV and possible cellular changes.
Is vaccination only necessary for girls?
The vaccination is intended for both girls and boys between the ages of 9 and 14, because boys can also be carriers of the HPV virus.
Does the HPV vaccine affect fertility?
The vaccine is safe and has no effect on fertility. There is no scientific evidence to indicate a link between vaccination and infertility. Results from the Republic of Moldova and over 100 countries confirm this fact.
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