The Network of Expertise in Cervical Cancer Prevention

Coordinating Access to Knowledge, Skills and Expertise to Support the Establishment of Cervical Cancer Prevention Programmes in Eastern Europe and Central Asia

Over the past 20 years, there have been many projects to improve cancer prevention in Eastern Europe and Central Asia. However, the outcomes have been poor because most projects targeted a single health service so the problems remaining in the other services required to run the prevention programs still prevented the overall prevention system from working effectively. Using cervical cancer as an example, improving colposcopy services will not do much to reduce cervical cancer rates unless the health services required to identify women needing treatment, refer them to colposcopy and make sure they go to colposcopy also work effectively [1-4]. As a result, the number of new cancers and the number of deaths from cancer have remained the same or even increased in some countries [5,6].

Effective cervical cancer prevention programmes require many health services to be of high quality and to be well coordinated. Therefore, the poor performance or coordination of any health services will reduce the effectiveness of the programme, even to the point that it has no effect at all [1-4]. This means that projects to implement or improve cervical cancer prevention programmes must start by identifying the health services as well as the coordination mechanisms that need to be improved and then work on all of these simultaneously so the performance of the overall programme can be improved.

Fortunately, many countries in Western Europe, North America, Australasia, etc. have a large amount of expertise and knowledge across all the required health services, with some of these countries being global leaders in cancer prevention. Therefore, the problem is not the lack training expertise, but instead how to make this expertise available in a way that can be matched to the needs of the countries that are now in the process of implementing their programmes.

In recognition of this problem, the European Network of Expertise in Cervical Cancer Prevention was established to:

  1. Identify organisations in countries with successful prevention programmes that are willing to make their expertise available to their colleagues in the Eastern European and Central Asian region.
  2. Prepare a database of training opportunities that can be matched to the needs of the countries that are now in the process of implementing their programmes.

In other words, the European Network of Expertise in Cervical Cancer Prevention operates as a mechanism to match the training resources that are available in Western Europe, North America, Australasia, etc. with the training needs of the Eastern European and Central Asian countries that are working to implement their cervical cancer prevention programmes. But very importantly, to do this in a coordinated way that will allow these countries to build capacity across all the services needed to deliver an effective cervical cancer prevention programme.

References:

  1. IARC. Breast Cancer Screening. IARC Handbooks of Cancer Prevention. Vol. 7. Lyon: IARC Press, 2003
  2. IARC. Cervix Cancer Screening. IARC Handbooks of Cancer Prevention. Vol. 10. Lyon: IARC Press, 2005
  3. European Commission. European Guidelines for Quality Assurance in Breast Cancer Screening (Fourth Edition) Perry N, Broeders M, de Wolf C, Tornberg S, Holland R, von Karsa L (eds). Office for Official Publications of the European Communities, Luxembourg (2004)
  4. European Commission. European Guidelines for Quality Assurance in Cervical Cancer Screening (Second Edition). Arbyn M, Anttila A, Jordan J, Ronco G, Schenck U, Segnan N, Wiener HG, Herbert A, Daniel J, von Karsa L (eds). Office for Official Publications of the European Communities, Luxembourg (2008)
  5. Ferlay J, Shin HR, Bray F, Forman D, Mathers C and Parkin DM. GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from: globocan.iarc.fr
  6. Arbyn M, Antoine J, Magi M, et al. Trends in cervical cancer incidence and mortality in the Baltic countries, Bulgaria and Romania. Int J Cancer 2011;128:1899–1907