Providers’ constructions of the role of women in cervical cancer screening in Bulgaria and Romania

HPV prevalence and type distribution in women with normal or abnormal Pap smear in Bulgaria

“…The most frequently detected virus type in the studied samples was HPV 16 (45.6%), followed by HPV 33 (13.8%). This data on the proportion of HPV 33 was similar to the data, obtained by similar studies in other Balkan countries as FYROM (HPV 33-7.1%), Montenegro (HPV 33-7.1%), Serbia (HPV 33-7.1%), Bosnia and Herzegovina (HPV 33-7.1%), Romania (HPV 33-7.1%), and Albania (HPV 33-7.1%) [Todorova et al, 2006]. These results differ from those obtained in the study of patients in countries such as Turkey and Cyprus in which the second most common type detected was HPV 58 (12.2% of the patients studied), Greece HPV 31 (12.8%), and Croatia (HPV 31-9.5%) [Castle et al, 2008].…”

“…These results were closer to countries like Montenegro (HPV 31–6.8%), FYROM (HPV 31–6.8%), Serbia (HPV 31–6.8%), Bosnia and Herzegovina (HPV 31–6.8%), and Albania (HPV 31–6.8%). The third highest type in detection was different for the various Balkan countries like Croatia (HPV 33–6.3%), Turkey (HPV 52–9.5%), Cyprus (HPV 52–9.5%), Greece (HPV 18–10.3%), and Romania (HPV 18–4.9%) [Todorova et al, ], compared to results obtained by the research approach in similar studies of patients from other European countries like Norway (HPV 31–9.0%), Finland (HPV 31–10.5%), Latvia (HPV 31–10.5%), Italy (HPV 31–6.4%), Hungary (HPV 31–5.3%), and Andorra (HPV 31–6.8%) [Castle et al, ; Lenselink et al, ; Menzo et al, ; Mariani et al, ; Bernard et al, 2013].…”

“…HR-HPV DNA testing has been proposed as a tool for primary cancer screening [zur Hausen, 2002;Castle et al, 2008] or as an adjunct test for the treatment of patients with the equivocal cytological finding of atypical squamous cells of undetermined significance (ASC-US) . It has been demonstrated that specific identification of HR-HPV can highlight patients at greater risk for developing cervical intraepithelial neoplasia of grade 3 or higher [Gravitt et al, 1998[Gravitt et al, , 2000TaeJeong et al, 2004;Todorova et al, 2006;van Hamont et al, 2006;Halfon et al, 2010]. With that end in view, HR-HPV cocktail tests such as the Linear Array (LA) test (Roche) are usually employed.…”

Inequalities in cervical cancer screening in Eastern Europe: perspectives from Bulgaria and Romania

“…Women and providers perceive this as a major barrier to accessing screening 18,35 . The structural barriers the women faced in the healthcare system were a major predictor of absence of cervical screening history, and also a major mediator of the effects of socioeconomic status on screening for both countries.…”

‘I do not need to… I do not want to… I do not give it priority…’– why women choose not to attend cervical cancer screening

“…that all women should have a cervical smear taken. Instead of blaming them for their non‐attendance, 4,5 we argue that attention should be paid to the individual woman to understand her decision not to attend CCS. This study was undertaken by researchers working at the university and the first author has previously worked as a midwife in the CCS programme.…”