Description
Women belonging to disadvantaged categories have an increased risk of cervical cancer and a higher mortality rate related to cancer because the disease often is detected only in advanced stages. The objective of the project is to improve the health status and well being of Roma and other women from disadvantaged groups (RODG) by providing increased access to the cervical cancer control program. The project is expected to identify barriers to participation in to the cervical cancer screening program, to pilot HPV screening and to develop an IT platform for cancer registration and control. The project will be carried out by a multidisciplinary team of professionals from Romania and Norway trained in public health, medicine and information technology. the groups expected to benefit from the project are primarily women in RODG from the North-Western region of Romania, but the project will also increase the cancer surveillance capacity for the whole population of the region. the donor partner is the Cancer Registry of Norway (Kreftregisteret) which has high expertise in cancer registration and population- based cancer screening programs. The partnership will align Romanian standards in working on screening and cancer registries to those of the European Union.
Summary of project results
Romania is known to have the highest incidence and mortality from cervical cancer in Europe due to the absence of an organized screening program in the last decades. Since 2012, the Ministry of Health has implemented a nationally organized program based on conventional cytology. Industrialized countries have reconsidered screening programs recommending HPV testing in women aged over 30 and a gradual transition to HPV testing due to higher efficacy. HPV testing in screening for cervical cancer was not evaluated in population programs in Romania. Increased efficiency and better allocation of resources to be promoted following project results is expected to contribute substantially to ensuring the economic sustainability of the national screening program. The project included specific approaches for those in need and vulnerable due to socio-economic and geographical barriers, particularly Roma women. Such benefits of the project include greater equity in access to health services, better quality of life, and social capital conservation. The European Guidelines for Quality Assurance of Cervical Cancer Screening recommend linking cancer registry data and screening data. Accordingly, the implementation of screening programs also requires the extension and improvement of cancer registration. In the cross-sectional study carried out within the project, Roma women were less likely to be present than non-Roma women. The most important barriers to screening were lack of knowledge about programs and lack of money even if the screening program should be free of charge. Both health authorities and women have a role in creating the necessary understanding to promote women's inclusion in the Romanian screening program. The new OncReg Electronic Reporting Platform is fully functional and has entered into the current practice. We have also developed the Northwest Regional Cancer Registry Quality and Management Plan to ensure project sustainability. The NWCanPortal Portal is the most sustainable product of the project. We have proved that integration of HPV testing into organized screening is feasible for women from disadvantaged socio-economic groups without health insurance from remote rural areas, via a mobile unit, to increase accessibility to screening. We have delivered a HPV laboratory equipped and functional and a quality assurance protocol. The results obtained will be the basis of the strategies for the prevention of cervical cancer in Romania.
Summary of bilateral results
The Norwegian Cancer Registry is the organization responsible for cancer registration in Norway, as well as the national cervical cancer screening program. Thus, given that the objectives of the project in Romania are related to the improvement of the quality of cancer registration, as well as to the screening of cervical cancer, there is a perfect match between the scientific and public health interests between the institutions in Romania and Norway. In fact, the only organization in Norway that would meet the partnership criteria in this collaboration is indeed the Cancer Registry of Norway. The Norwegian partner contributed to the project through the experience and advanced level of knowledge about HPV screening that has been implemented in some regions of Norway since 2015. The work visits made by the Romanian partner to the Oslo Cancer Registry have contributed to enriching the knowledge about the organization of cervical cancer screening programs and outlining the most appropriate and appropriate ways of approaching the project. The project partner participated in the initial meeting where the main project activities and subsequent meetings were planned, with continuous monitoring of the way the project phases are being carried out. The Norwegian partner was the Leader of Work Package 3 on the study of barriers to access to cervical cancer screening and carried out laborious work on the ground by participating for 3 months in the life of the studied communities, as well as collecting and analyzing the data. It has also contributed through technical expertise to the evaluation of the results obtained in Work Package 5. Following this partnership, bilateral relations are expected to continue in areas of common interest, such as in the field of oncology screening, through future scientific projects in breast and colorectal cancer screening. Additional measures to strengthen partnership and closer bilateral collaboration include the preparation of future projects in areas of common interest with a positive social impact potential, as well as the sharing of experience derived from this project, with the possibility of training the staff involved in scientific research.