The Dutch cervical cancer screening programme has been organised nationally and uniformly since 1996. In 2017, the cervical cancer screening programme changed. 

Until that time, the screening consisted of the cytological evaluation of a smear test taken at the GP practice. From that moment onwards, the target group of people aged 30 to 60 received an invitation to have a pap smear taken at the GP practice every five years. The collected cells were evaluated microscopically for cellular abnormalities (cytological evaluation) in a laboratory. Depending on the result, follow-up testing took place after six months or after referral to a gynaecologist.

2017: Primary HPV screening

In 2017, the screening programme changed. The main changes were the introduction of primary HPV screening followed by a cytological evaluation in the event of a positive HPV result and the introduction of the self-sampling kit. In addition, a change was made to the algorithm for referral.

As a result of this innovation, a number of outcomes of the screening have changed. The number of detected cancer precursors has risen by more than a quarter. In addition, the number of referrals has more than doubled. Another (unintended) side effect has been the drop-off in the participation rate from around 65% to around 56%. It appears that a large part of the target group intends to take part, but ultimately does not.