History and developments

History

Systematic screening for cervical cancer began in the Netherlands in 1976. In the early days, women between the ages of 35 and 53 were invited for testing once every three years. In 1994, the cervical cancer screening programme was restructured. The main changes were as follows:

  • The target group was extended to include all women between the ages of 30 and 60.
  • The screening interval was increased from 3 to 5 years.
  • Withdrawal of the policy of recommending retesting in cases where no endocervical cells are present in a negative sample (from 1 January 2002).
  • The period between an initial test and a retest was reduced from 18 months to 6 months.

The principal aims of the changes were:

  1. To maximise the programme's coverage by extending the target group.
  2. To increase the participation rate by reducing opportunistic screening.
  3. To reduce the frequency with which retesting was recommended.
  4. To reduce the average interval between initial testing and retesting.
  5. To avoid increasing the cost of the programme by keeping the total number of testing cycles in a woman's lifetime at 7.
  6. To ensure that the programme was acceptably cost-effective.

All those aims were achieved and secured.

Developments

In May 2012, the Health Council advised the minister on improvement of the cervical cancer screening programme. The minister indicated that it was necessary to carry out a feasibility study since complex changes were proposed. This feasibility study was carried out bij RIVM-CvB together with other parties involved.

In March 2013 the minister decided to use hrHPV sreening in the cervical cancer screening programme. This will prevent 75 extra cases of cervical cancer en 18 people dying of cervical cancer every year. The minister adopted the most important recommendations of the Health Council and the feasibility study. The minister also decided to provide a self abstraction kit. Women who do not make an appointment for a pap smear can apply for a self abstraction kit.

The preparations for the renewal of the cervical cancer screening programma started in 2014. The implementation of the improved screening programme needs to be carried out accurately. The feasibility study provides a framework. Professionals are involved closely in the preparations. In 2016 the renewed cervical cancer screening programma will be implemented.

International

The Netherlands has a well-organised screening programme. The Dutch programme is similar to the Finnish programme, except insofar as there is considerable opportunistic screening in Finland. Many European countries have no systematic screening programme. This often leads to more intensive screening and to screening at an earlier age.

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