Prof Mihaela Grigore from Grigore T. Popa University of Medicine and Pharmacy shared Romania’s evolving approach to improving cervical cancer screening outcomes at EUROGIN 2025. Since the launch of the national screening program in 2012 with free Pap smears offered every 5 years, Romania has faced challenges with low participation, weak infrastructure, and poor quality control, resulting in a low screening coverage of 18%.

To address these gaps, she highlights recent reforms, including the reintroduction of HPV vaccination, shifting to HPV primary screening and improving coverage via expanded self-sampling and mobile outreach, and the introduction of pap or p16/Ki-67 dual stain cytology triage for HPV-positive women in 2024. As HPV testing identifies more women with minor pap cytology abnormalities or glandular lesions, she discusses how p16/Ki-67 dual stain cytology may improve diagnostic accuracy, reduce unnecessary colposcopies and avoid overtreatment. She discusses a study published by her team which showed that p16/Ki-67 dual stain outperforms HPV testing in younger women under 30 years old with abnormal cytology, supporting its potential use as a triage tool in managing ASCUS/LSIL cases prior to colposcopy referral for this subset of women.st