Cervical cancer screening in Europe and Romania: a review of policies, progress, and persistent disparities.

Cervical cancer remains one of the leading causes of cancer-related death among women globally, despite being largely preventable through human papillomavirus (HPV) vaccination and regular screening. While many European countries have made significant progress in reducing incidence and mortality, Romania continues to report the highest rates within the European Union. This narrative review synthesized data from PubMed, Web of Science, Embase, and Google Scholar to evaluate cervical cancer screening policies across Europe, with a particular focus on Romania. The review included studies on HPV vaccination, cytology- and HPV-based screening, national program implementation, and public health strategies. Countries with organized, population-based screening programs and high HPV vaccine coverage, such as the Netherlands, Finland, and the UK, demonstrate lower incidence and mortality. In contrast, Romania faces persistent systemic barriers: limited public awareness, insufficient infrastructure, low screening participation (<20%), and suboptimal HPV vaccine uptake. Efforts to align national policies with WHO and EU cancer control strategies remain fragmented. Romania illustrates the deep disparities in cervical cancer prevention within Europe. Strategic reforms, including transitioning to HPV-based screening, expanding access to vaccination, enabling self-sampling, and enhancing public education, are critical. Integration into broader EU frameworks such as Europe's Beating Cancer Plan may accelerate progress. While the tools for cervical cancer prevention are well established, Romania's case underscores the need for systemic, context-specific interventions to reduce disease burden and promote equity across Europe.