LYON, France — For many women in Georgia, preventive reproductive health care is not a regular part of their lives. As a result, many who are diagnosed with cervical cancer learn they have the disease only after it has already spread.

“Women in Georgia often perceive it as shameful to talk about intimate parts of their bodies with a doctor, and so they postpone a visit until it is too late,” says Dr. Sophie Bojgua, a obstetrician-gynaecologist at the David Gagua Clinic in Tbilisi.

Thanks to a UNFPA-supported training programme, Dr. Bojgua is now helping change that, by raising awareness about cervical cancer among the public, and helping her colleagues work to improve the Georgian health-care system’s approach to cervical cancer prevention.

Cervical cancer is the only preventable cancer of the reproductive system, but countries across the Eastern Europe and Central Asia region often lack formal cervical cancer prevention programmes. As result, the number of new cases and deaths caused by cervical cancer in the region is ten times higher than it is in the European Union.

Filling capacity gaps

Dr. Bojgua is part of the second cohort of medical professionals from Eastern Europe and Central Asia to successfully complete a Regional Training Programme in Colposcopy and Cervical Pre-Cancer Management launched in 2016 by UNFPA, the International Agency for Research on Cancer (IARC) and the International Federation of Cervical Pathology and Colposcopy (IFCPC). The programme comprises six months of online training, followed by  clinical case-management sessions conducted in a colposcopy clinic under the supervision of a trainer who was trained by IFCPC and IARC.

After completing the course, participants take an objective structured clinical examination. This test was administered in Lyon, France, to the first cohort in late 2017 and to Dr. Bojgua’s group in May 2019. With a success rate of more than 98% on both exams, the programme has to date resulted in a pool of more than 50 internationally certified professionals from all countries and territories in the region. They can now train colleagues and treat pre-cancerous conditions among patients in their home countries in full accordance with the latest international standards.

“Progress in preventing cervical cancer depends on progress in advancing screening programmes and strengthening institutional capacities,” says certified trainer Dr. Madona Jugeli, who applies her expertise to cervical cancer prevention programmes at the national and regional levels.

“The problem of cervical cancer is very urgent for my country due to low awareness of the problem, and an absence or lack of qualified health workers, laboratory technicians and necessary equipment to screen and prevent cervical cancer,” says Dr. Nurgul Shoonaeva from Kyrgyzstan, who also participated in the training programme and took the exam in May.

Implementing organized cervical cancer screening programmes – the most effective way to prevent the disease or treat it at early stages – is similarly challenging across the region, where countries lack the necessary trained human resources, medical equipment, screening registries and statistical data. UNFPA’s training programme is helping to fill those capacity gaps.

Boosting knowledge and confidence

“The success rate demonstrated by the trainees in both rounds of the objective structured clinical examination in Lyon is good evidence of the dedication and capacities of service providers from countries in our region to benefit from international training opportunities and to apply that knowledge to national efforts on cervical cancer prevention,” says Dr. Tamar Khomasuridze, UNFPA’s Regional Sexual and Reproductive Health Adviser for Eastern Europe and Central Asia. “Continuing to make high-quality international training resources available in local languages, in an affordable and accessible way, is key to preventing and eliminating cervical cancer in the region.”

Dr. Bojgua from Georgia credits the UNFPA-supported training with giving her the “knowledge and confidence” to share information on the topic of cervical cancer prevention, both with her medical colleagues and with the broader public.

“About a month after the exam, I held a meeting with my colleagues on this topic, and I was recently invited on a TV show to talk about it,” she says. “This training was a big step personally for me as a doctor, but I believe it has an effect on a bigger scale, too.”