TASHKENT – On September 28, a final conference was held on the results of a pilot project on HPV testing for cervical cancer screening, organized by the Ministry of Health of the Republic of Uzbekistan with the support of the United Nations Population Fund (UNFPA).

The purpose of this event was to present and discuss the results of the pilot project "HPV Testing for Early Detection of Cervical Cancer" aimed at evaluating the effectiveness of HPV testing for primary screening of cervical cancer in the context of the Uzbek health system under the Joint UNDP-UNFPA program called "Strengthening the resilience of local communities in the Aral Sea region to environmental, economic and public health vulnerabilities”, funded by the Government of Japan, and develop a roadmap for the further introduction of HPV testing into the national cervical cancer screening program. The pilot was conducted in the Chirchik city (4 PHC polyclinics) and in the Republic of Karakalpakstan (11 PHC polyclinics) from April 1, 2021 to April 30, 2022.

The conference was attended by representatives of the Ministry of Health of the Republic of Uzbekistan, UNFPA, international experts, GPs, obstetrician-gynecologists, oncologists, etc. During the event, in addition to the main reports, work was carried out in small groups to develop a screening program for cervical cancer in the Republic of Uzbekistan. Cervical cancer is a major public health problem in Uzbekistan, where it ranks as the 2nd leading cause of death from cancer among women aged 15 to 45 years. 

During the conference, speakers reported that in the course of their joint work 49140 (98%) tests were performed, of which 3290 (6.7%) were positive for the presence of the virus in the body. All patients with identified pathology were referred for further consultations and treatment of narrow specialists. 759 (23%) tested women with HPV-positive status were referred to oncology, 9 women (1.2%) of women referred to oncology underwent surgical treatment of cervical cancer, 237 (31%) HPV-positive women with identified minimal lesions on the cervix underwent thermal ablation or radio wave coagulation in the clinic.

This project aims to detect cervical cancer at an early stage when proper treatment can lead to a 100% cure for the patient. All the results obtained during the implementation of the program were submitted to the Ministry of Health of the Republic of Uzbekistan for the development of the National Strategy for the Prevention of Cancer, including cervical cancer.

Implementation and launch of the pilot project was a complex operation involving many activities, including: acquisition and delivery of new equipment; training health care workers to perform screening tests and triage women with positive screening results; monthly follow-up visits to assess progress and solve problems, etc. Within the framework of the project, 45 gynecologists, 150 family doctors, 270 visiting nurses and 77 midwives of primary health care in the Republic of Karakalpakstan were trained to conduct HPV testing to determine the early stages of cervical changes among 50,000 women aged 30 to 55. The trainings were conducted by specialists of the Republican Scientific and Practical Specialized Center for Obstetrics and Gynecology of the Ministry of Health of the Republic of Uzbekistan.

In January 2021, as part of the project, equipment and a test system for detecting the human papillomavirus (HPV) were procured. In particular, 8 machines and 50,000 tests were installed in district polyclinics. Republic of Karakalpakstan, with the financial support of the government of Japan. With the support of UNFPA, additional 2 machines and 6,000 tests were purchased for screening studies in the city of Chirchik, as part of a joint pilot project with the World Health Organization on screening for cervical cancer in the Tashkent region. In order to ensure the treatment of patients with inflammatory lesions on the cervix discovered during the project, 3 radiocoagulation units were purchased and installed at the district level.

Cervical cancer caused by human papillomavirus (HPV) continues to be a major public health problem worldwide. According to the World Health Organization, more than 300,000 women die from cervical cancer every year. In Uzbekistan, as well as worldwide, cervical cancer is the second most common cancer among women of all ages and the second most common cause of death among women of childbearing age after breast cancer. In 2020, cervical cancer was responsible for 1,650 new cases and 1,000 deaths, but analysis of incidence and mortality rates over time shows that they are steadily increasing and are estimated to reach 10.15 and 6.46, respectively, by 2030, when cancer cervical cancer will cause 2,100 new cases and 1,300 deaths per year.

It is worth noting that the Ministry of Health of the Republic of Uzbekistan and UNFPA are actively cooperating within the framework of the signed document of understanding dated 06/05/2020 on strengthening the capacity of healthcare institutions in order to develop and implement a comprehensive reproductive health strategy and provide an integrated package of basic services, including maternal health and HIV prevention, with a focus on the rural population, as well as on the population of territories exposed to environmental disaster in the Aral Sea region.

UNFPA activities in Uzbekistan began in 1993 and today the agency is implementing the fifth Country Program (2020-2025) in close cooperation with national partners.