Quality assurance and improvement of cancer screening programs require up-to-date monitoring systems and evidence-based indicators. The Nordscreen database [1] is planned to include performance and outcome indicators for cervical cancer screening programs in the Nordic countries and Estonia. The tool will be publicly available and facilitate comparison of cancer screening programs over time and between the Nordic countries.
The screening data originates from population-based mass screening registries in each of the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) and Estonia. Comparability between countries is ensured by using uniform data structure. The developed indicators are based on the European guidelines for cervical cancer screening and other ongoing research projects. [2] Fact sheets summarising the cancer screening policies and programs in place in all the Nordic countries and Estonia will be created to provide context for the indicators.
Currently cervical cancer screening test coverage data is available from Norway (years 1992 - 2015) and Finland (1991 - 2014) with other Nordic countries and Estonia to be included soon. The test coverage within screening interval of 3 years in age group 30-59 was 75.0% in Norway in 2014 (60.4% in Finland). Test coverage in 2014 increased to 90.4% in 10-year follow-up in Norway (82.2% in Finland). The application can be present data in graphical or table form based on user specifications such as follow-up time, calendar year and age group.
Lower test coverage in Finland can be explained by policy of 5-year screening interval and that mass screening registry in Finland only includes tests that are provided within the organized screening process whereas Norwegian data also includes opportunistic screening tests. Despite some limitations, the performance and outcome indicators are likely to be relevant to many stakeholders such as researchers, policy makers and journalists. In the future, the database may also be expanded to on-going screening programs for breast cancer and colorectal cancer.
[1] Lönnberg S, Dillner J, Elfström M, Bzhalava D, Bzhalava Z, Sarkeala T, Heinävaara S, Anttila A. NORDSCREEN: Performance and outcome of cancer screening in the Nordic countries, Version 1.0 (2017). NIASC Nordic Center of Excellence in Health-related eSciences. Karolinska Institutet. Available from http://www.nordscreen.org, accessed on 26/04/2017.
[2] Arbyn E, Anttila A, Jordan J, Ronco G, Schenck U, Segnan N, Wiener H, Herbert A, Daniel J. European guidelines for quality assurance in cervical cancer screening. 2nd ed. Luxembourg: Office for Official Publications of the European Communities; 2008.