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This article provides an overview of cervical cancer and other human papillomavirus (HPV)-related diseases in Central and Eastern Europe (Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia, and the Former Yugoslav Republic [FYR] of Macedonia) and Central Asia (Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine and Uzbekistan). Despite two- to three-fold variations, cervical cancer incidence rates are high in many countries in these two regions relative to other populations on the European and Asian continents. In Central and Eastern Europe, Romania and the FYR of Macedonia had the highest rates in 2008 alongside Bulgaria, Lithuania and Serbia, while in Central Asia, rates are elevated in Kyrgyzstan (the highest rates across the regions), Kazakhstan and Armenia. In each of these countries, at least one woman in 50 develops cervical cancer before the age of 75. The high cervical cancer burden is exacerbated by a lack of effective screening and an increasing risk of death from the disease among young women, as observed in Belarus, Tajikistan, Kyrgyzstan, Armenia, Azerbaijan, Ukraine, the Russian Federation and Kazakhstan. In several countries with longstanding cancer registries of reasonable quality (Belarus, Estonia and the Russian Federation), there are clear birth cohort effects; the risk of onset of cervical cancer is increasing in successive generations of women born from around 1940–50, a general phenomenon indicative of changing sexual behaviour and increasing risk of persistent HPV infection. There are limited data for other HPV-related cancers and other diseases at present in these countries. While options for reducing the HPV-related disease burden are resource-dependent, universal HPV vaccination with enhanced screening would maximally reduce the burden of cervical cancer in the countries within the two regions. It is hoped that the expanded second edition of the European Guidelines will finally kick-start effective interventions in many of these countries that still lack organised programmes. This article forms part of a regional report entitled “ Comprehensive Control of HPV Infections and Related Diseases in the Central and Eastern Europe and Central Asia Region” Vaccine Volume 31, Supplement 7, 2013. Updates of the progress in the field are presented in a separate monograph entitled “ Comprehensive Control of HPV Infections and Related Diseases” Vaccine Volume 30, Supplement 5, 2012. [ABSTRACT FROM AUTHOR]

Limited data are available on the burden of human papillomavirus (HPV) and its associated diseases in the Russian Federation, the Western Countries of the former Soviet Union (Belarus, Republic of Moldova, Ukraine), the Caucasus region and Central Asia (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan). Both the incidence and mortality rate of cervical cancer are higher in these countries than in most Western European countries. In this article, we review available data on HPV prevalence and type distribution in women with normal cytology, women from the general population, cervical precancerous lesions and cervical cancer, as well as data on national policies of cervical cancer screening and HPV vaccination initiatives in these countries. Based on scarce data from the 12 countries, the high-risk HPV (hrHPV) prevalence among 5226 women with normal cytology ranged from 0.0% to 48.4%. In women with low-grade cervical lesions, the hrHPV prevalence among 1062 women varied from 29.2% to 100%. HrHPV infection in 565 women with high-grade cervical lesions ranged from 77.2% to 100% and in 464 invasive cervical cancer samples from 89.8% to 100%. HPV16 was the most commonly detected hrHPV genotype in all categories. As the HPV genotype distribution in cervical diseases seems to be similar to that found in Western Europe the implementation of HPV testing in screening programs might be beneficial. Opportunistic screening programs, the lack of efficient call-recall systems, low coverage, and the absence of quality assured cytology with centralized screening registry are major reasons for low success rates of cervical cancer programs in many of the countries. Finally, HPV vaccination is currently not widely implemented in most of the twelve countries mainly due to pricing, availability, and limited awareness among public and health care providers. Country-specific research, organized nationwide screening programs, registries and well defined vaccination policies are needed. This article forms part of a Regional Report entitled “ Comprehensive Control of HPV Infections and Related Diseases in the Central and Eastern Europe and Central Asia Region ” Vaccine Volume 31, Supplement 7, 2013. Updates of the progress in the field are presented in a separate monograph entitled “ Comprehensive Control of HPV Infections and Related Diseases ” Vaccine Volume 30, Supplement 5, 2012. [ABSTRACT FROM AUTHOR]