Organization of services is crucial when considering introduction of primary HPV screening.
The presentation discusses organizational and implementation issues of primary HPV screening as presented and recommended in the European guidelines Supplement (1).
Key elements of organized screening programmes with primary HPV testing include:
- Adopting a well-defined, evidence-based screening policy
- Establishment of an autonomous, accountable team responsible for programme coordination and provision and quality of the screening services
- A call–recall system for inviting all eligible women to attend screening and for recall of women to repeat examinations or to additional examinations to assess abnormalities detected in screening
- Quality-assured detection, diagnosis and treatment services in all steps
- Centralized data systems to run the programmes
- Regular monitoring based on the centralized data systems
- Screening databases linked to population, cancer, mortality, and vaccination databases and to other relevant registers in health services. These results should be used to prepare regular evaluation, and information to population at large and the various stake-holders.
In addition the guidelines Supplement recommends evidence-based strategies to improve the current attendance to the existing cervical cancer screening programmes.
Many European countries do not yet have a population-based screening programme for cervical cancer, but service has been provided historically mainly through opportunistic practices. In several countries underperforming of cytology-based programmes have also been reported, indicating e.g. lack of coherence within the screening and clinical management services or very low level of participation of the targeted population. These conditions cause challenges in organizing the screening services appropriately.
Anttila A, Ronco G, Nicula F, Nieminen P & Primic Žakelj M (2015). Organization of cytology-based and HPV-based cervical cancer screening. S2. In: European guidelines for quality assurance in cervical cancer screening. Second edition, Supplements. Anttila A, Arbyn M, De Vuyst H, Dillner J, Dillner L, Franceschi S, Patnick J, Ronco G, Segnan N, Suonio E, Törnberg S & von Karsa L (eds.). Office for Official Publications of the European Union, Luxembourg, pp. 69–108.