The Stark Reality: Cervical Cancer in Romania

An analysis by the National institute of Public Health in 2024 revealed a concerning trend: Romania leads in both new cervical cancer diagnoses and related deaths within Europe. This alarming statistic underscores a critical public health challenge, especially considering that cervical cancer is largely preventable through vaccination and screening [[2]].

In 2023, Romania recorded 2,880 new cases of cervical cancer, and tragically, 1,177 women succumbed to the disease. This places cervical cancer as the third most common cancer among women in Romania, following breast and colorectal cancer.This contrasts with the broader European profile, where lung cancer is also a significant concern [[1]].

HPV: The Primary Culprit

The human papillomavirus (HPV) is responsible for over 95% of cervical cancer cases. This virus infects the skin and mucous membranes, leading to cellular changes that can, over time, develop into cancer.Fortunately,HPV vaccination offers substantial protection against cervical dysplasia and cervical cancer,including both squamous cell carcinoma and adenocarcinoma.Furthermore, the vaccine can also guard against other HPV-related cancers affecting the anus, oropharynx, vulva, vagina, and penis.

Vaccination Hesitancy: A Major Obstacle

Despite the availability of effective HPV vaccines, Romania struggles with low vaccination coverage. A study by Save the children Romania highlighted a significant lack of interest and even fear surrounding HPV vaccination. This is notably disheartening given that a national vaccination program, offering free vaccination to girls aged 10-11, was initiated in 2008. However, the program was met with considerable resistance and was subsequently halted for nearly a decade before being relaunched in 2019, targeting girls aged 11-18. Currently, free vaccination is extended to both girls and boys aged 11 and older.

Expert Insights on HPV and screening

According to Dr. Elena Gheorghe, an obstetrics-gynecology specialist, most people will encounter HPV in their lifetime, but the majority will naturally clear the virus.

Very many people make contact with the HPV virus, throughout their lives, more precisely over 80%. but, more than 90% of people who have come in contact with it will have a clearance, that is, they will naturally get rid of this virus.
dr. Elena Gheorghe, obstetrics-gynecology specialist

Dr. Gheorghe emphasizes that even infection with high-risk HPV strains does not automatically equate to cancer. Though, it necessitates careful monitoring. She also stresses the importance of HPV genotyping, which involves testing for the presence of the virus, starting at age 30, in conjunction with the Pap test (Babeș-Papanicolau test). She notes that the Pap test alone is insufficient, as women under 30 frequently enough clear the virus naturally.

The Accessibility Gap in HPV Genotyping

A significant challenge lies in the limited accessibility of HPV genotyping in Romania. Dr. Gheorghe points out that in many Western European countries, HPV genotyping is state-funded, making it readily available. The lack of widespread access in Romania represents a critical gap in preventive care.

Moving Forward: A Call to Action

Addressing the cervical cancer crisis in Romania requires a multi-pronged approach. This includes increasing HPV vaccination rates through targeted education campaigns to dispel fears and promote the benefits of vaccination. Moreover, improving access to HPV genotyping, particularly for women over 30, is crucial for early detection and intervention. By prioritizing prevention and early detection, Romania can significantly reduce the burden of cervical cancer and save lives [[3]].