Barriers of organized cervical cancer screening in Albania and Montenegro.

Background: Organized cervical screening is vital for preventing cervical cancer. However, many existing screening programs fail to achieve their full potential, as demonstrated by core performance indicators. There are barriers that hinder the implementation and reduce effectiveness of the programs. This article explores barriers of cervical cancer screening in two Southeastern European countries, Albania and Montenegro, aiming to inform targeted strategies to improve healthcare equity and outcomes for women. Methods: The barrier assessment followed the EU-TOPIA framework, designed to identify barriers to effective breast-, cervical-, or colon cancer screening. This approach relies on an iterative process performed by country representatives responsible for screening and researchers with expertise in screening program planning and evaluation. It includes three steps: comprehensive description of screening activities; identification of key barriers via a previously published tool; and comprehensive assessment of the identified key barriers. Results: The barrier assessment revealed shared challenges in cervical cancer screening in Albania and Montenegro. Both countries face difficulties in their invitation systems, limited outreach activities, and low participation rates. Fully integrated data systems at national level are absent, hindering program monitoring and data sharing. Financial constraints and resource limitations negatively affect program sustainability and quality, reducing public awareness and accessibility. Additionally, neither country has comprehensive up-to-date long-term strategies to support prevention and early detection efforts. Conclusions: Our study underscores the importance of addressing organizational barriers in cervical cancer screening to improve program effectiveness and accessibility. Aligning screening practices with EU and WHO standards is crucial for Albania and Montenegro as prospective EU members. Lessons from international best practices, such as integrating IT systems, employing multi-channel outreach strategies, and adopting legally supported long-term policies, offer actionable pathways for improvement. Policymakers should prioritize sustainable funding, centralized systems, and innovative approaches to overcome structural challenges. [ABSTRACT FROM AUTHOR]