The cervical cancer screening in the Netherlands will switch from cytology-based screening to primary hrHPV screening with cytology triage in 2017. The change was prompted by Dutch Health Council recommendations in 2011 to improve population screening for cervical cancer. The Health Council advised on hrHPV test criteria, choice of triage, screen intervals and methods to increase uptake using self-sampling for non-responders1. The route to implementation of these major changes in the Dutch national population screening programme in the Netherlands will be presented.
A feasibility study on implementation of the hrHPV screening and the self-sampling for non-responders was performed (2010-2012) through a collaborative effort by various stakeholders2. The study documented coordination, organisation and cost aspects for the primary process, laboratory QA, monitoring, evaluation and communication to professionals and population. The Dutch government approved implementation based on the results. Currently, we are detailing the practical implementation of quality requirements, communication materials, tendering procedures and IT configuration.
- Attention for the support of stakeholders is essential for successful implementation.
- The option for self-sampling and the 10 year screen interval provided prerequisites on applicable HPV tests.
- International guidelines3 for HPV DNA tests were a valuable resource for test selection.
- International guidelines for self-sampling are lacking and are desired.
- In addition, collaborative, international criteria for monitoring and evaluation, and laboratory QA are needed.
1 Health Council of the Netherlands. Population screening for cervical cancer. The Hague: Health Council of the Netherlands, 2011; publication no. 2011/07.
2 Feasibility study for improvements to the population screening for cervical cancer, 2013, van der Veen N, Carpay MEM, van Delden JA, Brouwer E, Grievink L, Hoebee B, Lock AJJ, Salverda-Nijhof JGW. http://www.rivm.nl/Documenten_en_publicaties/Wetenschappelijk/Rapporten/2014/september/Feasibility_study_for_improvements_to_the_population_screening_for_cervical_cancer_2013
3 Guidelines for human papillomavirus DNA test requirements for primary cervical cancer screening in women 30 years and older. Meijer CJ, Berkhof J, Castle PE, Hesselink AT, Franco EL, Ronco G, Arbyn M, Bosch FX, Cuzick J, Dillner J, Heideman DA, Snijders PJ. Int J Cancer. 2009;124(3):516-20.