In January 2017 the renewed cervical cancer screening programme based on primary hrHPV testing has been implemented in the Netherlands. For quality assurance - to ensure an optimal balance between the benefits and harms of screening - it is important to closely monitor the screening programme. Regular monitoring by calculation of screening indicators is required both to identify and solve specific bottlenecks that are impeding an efficient screening programme, and more generally to ensure that the public finances continually invested in the programme are spent in a responsible way. We calculated such a set of short-term screening process indicators, that are available early in the lifetime of the screening programme, to observe the effects of the renewed screening programme in the Dutch population.
We calculated the attendance rate (divided by regular screening and self-sampling) and the proportion of HPV positive tests by using data from the screening organisations. Information on all cytological and histological examinations of the cervix uteri taken in the Netherlands from January 2017 onwards were available and retrieved from the nationwide network and registry of histo- and cytopathology in the Netherlands (PALGA). By using these data, we calculated the proportion of cytological abnormalities, the detection rates of CIN and cervical cancer. All indicators are calculated by different age groups.
The first results of the new hrHPV-based screening programme in the Netherlands look promising. The number of HPV positive women is high, but not higher than expected. It is important to keep monitoring the effects of the screening programme, especially the number of women participating in the self-sampling, the rate of opportunistic screening and the number of women send to colposcopy, to ensure the quality of the programme. In the long term other screening indicators are important, such as the interval cancer rate.