A population screening programme is a systematic offer of medical examinations to screen for a specific disease among a population of apparently healthy, asymptomatic individuals. You can find general information about the Dutch cervical cancer screening programme in a fact sheet.

Aim and target group

The aim of the cervical cancer screening programme is to reduce mortality by detecting early stages of the disease. A precancerous stage is usually easy to treat, which can prevent cervical cancer from developing.
People between the ages of 30 and 60 are invited to take part in the cervical cancer screening programme every five or 10 years. The target group of the programme is women living in the Netherlands and transgender persons or people with an X/O gender registration and having a uterus.

Primary process

The primary cervical cancer screening process is shown here in diagram form. You can find facts and figures about the screening programme in the fact sheet.


The cervical cancer screening starts with the selection of people who are eligible to be invited. The screening ends by informing the participants of the results. Participants who, based on the results, require further diagnosis and possibly treatment are referred to regular healthcare providers.

Select

The screening organisation selects people who are eligible for an invitation based on their age. Data from the Key Register of Persons (BRP) are used for this. Persons who have cancelled or who are not eligible based on a previous result are not selected. Transgender persons or people with an X/O gender registration and a uterus can also take part. They have to register with the screening organisation once.

Invite

The screening organisation sends the invitations for the screening according to an established invitation schedule. People who are eligible for an invitation receive it around their birthday, along with the invitation leaflet. People aged around 30 who are invited for the first time receive an advance notification six weeks before the invitation. They also receive a specific invitation letter.
If the invitation is postponed due to pregnancy, the invitee will receive a new invitation letter six weeks after the birth. People who have not responded to the invitation will receive a reminder after 16 weeks.

Screen

The screening examination starts when the invitee makes an appointment at the general practitioner (GP) practice for a smear test. The smear is tested for the presence of high-risk HPV (hrHPV) at a screening laboratory. If hrHPV is present, a cytological evaluation is performed immediately to determine whether there are any abnormal cells. This is done on the same smear in the same laboratory.
People who find a smear test very unpleasant and therefore do not want to take part in the screening programme can apply for a self-sampling kit. They can use this to collect vaginal material themselves and then send this to be tested for hrHPV. The screening organisation sends the self-sampling kit to the applicant. The applicant sends the self-collected material to the laboratory by post. If the participant tests positive for HPV, a smear test is still needed for a cytological evaluation.

Communicate result

In the case of a smear test, both the GP and the participant are informed of the result and the accompanying advice. The results of a self-sampling kit are not communicated to the GP. The participant receives the results of the smear test or the self-administered test from the screening organisation. HPV-positive participants receive the result letter and the result leaflet. If the result is HPV-positive with abnormal cells (HSIL), the GP will try to inform the participant before the participant receives the result letter.

Refer

HPV-positive participants with cytological abnormalities will be advised to undergo further examination by a gynaecologist. They will receive a referral from their GP according to an established referral schedule. The gynaecologist's examination is not part of the screening programme.