Improving cervical cancer screening in the Republic of Moldova.

Volunteering to improve cervical cancer screening in the Republic of Moldova. Cervical cancer incidence and mortality rates are very high in the Republic of Moldova being 4 and 6 times higher respectively than in the UK. The incidence of all cancers in Moldova had increased from 2005, with cervical cancer the second commonest cancer among women in 2018 and the leading cause of cancer deaths in woman aged 15-44 years.  The Royal College of Pathologists (RCPath) in London was approached in 2016 by the Director General of the International Cervical Cancer Prevention Association, working with the United Nations Population Fund and the Ministry of Health in the Republic of Moldova, to help with the implementation of a national cervical screening programme in Moldova. The project involves building Moldova’s capacity for gynaecological cellular pathology and they wished to have two Moldovan histopathologists come to the UK for training.  Initially I and another UK based medical pathologist volunteered to visit Moldova and assess current equipment and practices. We visited several clinical laboratories in the capital city, Chisinau, and one regional laboratory. During the visit, training needs were discussed and a training plan agreed, to include training in the UK, improvement actions to be implemented in Moldova, and a follow-up training workshop to be held in Moldova. As a result, two Pathologists from Moldova were trained at Maidstone Hospital in Kent, under supervision of a consultant gynaecological pathologist and subsequently a training workshop was held in Moldova to built capacity to implement the screening program. Two UK gynaecological pathologist contributed to the training workshop for 15 Moldovan pathologists and they made further recommendations on laboratory services and training requirements. Early in 2018, the Moldova Cervical Cancer Prevention Week was launched to raise awareness about the need to prevent this disease. As a result of the project, over 760,000 Moldovan women aged 25-61 years are expected to benefit from improved cervical screening services. It is predicted that national cervical cancer incidence will decrease by 20% and the cervical cancer mortality will decrease by 5% over the next seven years.  The RCPath international department staff and medical fellows who volunteered to collaborate have played a major role in the implementation of this disease prevention initiative. I have benefitted from my involvement as RCPath international regional advisor by learning how to successfully engage and collaborate overseas towards improving health in a resource limited country