Sofia (name changed) has two sons and works at a state institution in the Drochia district. Her life follows a familiar rhythm: rushed mornings, responsibilities at work, evenings devoted to family. Yet she carries a quiet fear with her—the fear of a possible diagnosis.

This fear is not unique. In 2020, 36% of women who had not undergone a cytological test stated that fear of being diagnosed with atypical cells or a form of cancer remained one of the main barriers to cervical cancer screening, according to the post-intervention KAP Study conducted with the support of the United Nations Population Fund (UNFPA) and the Swiss Agency for Development and Cooperation (SDC).

And yet, Sofia went for regular check-ups. At first, she did so because it was a requirement of her job. Later, it became a deeper conviction: prevention is a form of care—for herself and for her children. Once every three years, even without any symptoms, she took the cytological test, also known as the Pap smear or PAP test.

The cytological test is a short and painless examination. The doctor collects cells from the cervix using a special brush, which are then analyzed under a microscope. In the Republic of Moldova, the test is recommended for all women aged 25 to 61 and is provided free of charge—including for uninsured women—through a simple appointment with a family doctor. In the country, coverage of cytological screening (Pap test) has increased significantly, from 36% in 2021 to over 62% in 2025.

A few weeks after her most recent Pap test, Sofia was contacted by her family doctor: the result indicated HSIL, a high-grade lesion caused by infection with the human papillomavirus (HPV). She was referred to the Drochia District Hospital, where, since 2023, a modern colposcopy unit has been operating as part of the National Colposcopy Network, which includes 12 medical institutions (nine in districts and three in Chișinău).

There, she will receive treatment for precancerous cervical lesions to prevent the development of cancer. In the Republic of Moldova, the treatment rate for precancerous cervical lesions has increased significantly, from 26% in 2021 to 91% in 2025. The treatment is free of charge and funded by the state budget.

Svetlana Nicov, a gynecologist and colposcopist with nearly 40 years of experience, coordinates the cervical screening service in the Drochia district.

“The old equipment did not allow us to perform biopsies, so women were referred to Bălți. With the opening of the Colposcopy Reference Center at the Mother and Child Institute, they were sent to Chișinău. Now, however, patients can access colposcopy services in the district where they live. The image is displayed on a monitor; the device is equipped with a video and photo system that allows us to save images, archive all examined cases, monitor progress, and store information. Women can see for themselves how the cervix looks before and after treatment,” she explains.

Svetlana Nicov is also involved in ongoing institutional training for nurses who perform Pap tests. In 2024 alone, 27 nurses from the Drochia district were trained not only in technical skills but also in empathetic communication with patients.

“For years, we used to see too many cases of cervical cancer at advanced stages. Today, the situation has changed dramatically: we detect more precancerous lesions and fewer cancer cases. Women now come with greater confidence, ask questions, and want to understand what is happening to them. We are also preparing an informational campaign and plan to organize a district forum where women can become true ambassadors of cervical screening, speaking openly about their experiences,” says Svetlana Nicov.

The team of family doctors in Drochia is actively involved in raising community awareness about health services, including cervical screening services offered free of charge to all women. They annually schedule eligible women from their service area and contact them by phone. More recently, starting in January 2026, family doctors have the option to invite women for cytology testing via electronic messages sent to their email addresses.

During 2024–2025, following cytology testing and colposcopy examinations, 319 cases of precancerous cervical lesions were detected among women in the Drochia district. Nationally, 600–700 women are diagnosed with such lesions each year.

Beyond the numbers, the impact is felt in communities. When Sofia shared her experience, she realized she was not alone. Some of her colleagues had gone through similar situations before and had to travel to Chișinău for diagnosis and treatment. By seeking timely care from family doctors and following medical advice, she is now living a healthy and active life.

In addition to being equipped with modern devices and medical furniture, the 12 colposcopy offices are staffed by well-trained and qualified doctors. The national network includes 20 colposcopists who have completed ongoing theoretical and practical training courses. In total, around 50 colposcopists have been trained nationwide.

“Today, in the nine districts, colposcopy and biopsy allow a complete diagnosis. Women travel to Chișinău only for excisional treatment of precancerous cervical lesions. The waiting time is a maximum of one week. If the diagnosis does not confirm a precancerous lesion, women remain under district-level monitoring,” explains Uliana Tabuica, gynecologist and head of the National Colposcopy Reference Center at the Mother and Child Institute.

The districts where the Colposcopy Offices operate were selected based on two main criteria: the size of the population served and the presence/availability of doctors who had previously been trained or expressed a desire to study and practice colposcopy. After training and thorough preparation in the field, gynecologists in the network receive continuous guidance from specialists at the National Colposcopy Reference Center through an online videoconference system.

“When they face difficulties in decision-making or diagnosis, we can provide real-time support, discuss more complex cases, and guide them step by step. Currently, in addition to precancerous cervical lesions, an increasing number of cervical cancer cases are being detected at early stages, when women do not yet show symptoms. Only through cytology testing, timely colposcopy, and biopsy can we detect both precancerous lesions and early-stage cervical cancer, when treatment is more effective, less invasive, and has a lower long-term impact on health, offering much higher chances of cure,” explains the head of the National Colposcopy Reference Center at the Mother and Child Institute.

Plans for 2026 are ambitious. Currently, the team of doctors, together with the authorities, is working to expand the number of districts served by these subnational colposcopy centers/offices. At the same time, efforts are underway to strengthen the capacity of colposcopists to treat detected precancerous cervical lesions, so that women can benefit not only from diagnosis but also from treatment directly in their district.

Sofia is one of the fortunate cases where cervical screening worked. A lesion detected on time, within a well-organized screening system with trained doctors and adequate conditions, means a life without fear. Yet, in the Republic of Moldova, every three days a woman still loses her life to cervical cancer. Cervical screening and HPV vaccination remain the most effective methods to prevent a disease that is almost entirely avoidable.

Over the years, UNFPA has supported national and local authorities in preventing cervical cancer through assistance in developing regulatory frameworks, equipping medical institutions, training personnel, digitalizing colposcopy services, developing digital data tracking systems, sending digital notifications to women invited for cervical screening, and running public awareness campaigns on cervical cancer prevention. The results are visible, and every story like Sofia’s confirms a simple truth: prevention saves lives.