Monitoring a national cancer prevention program: successful changes in cervical cancer screening in the Netherlands

Matejka Rebolj; Marjolein van Ballegooijen; Louise-Maria Berkers; Dik Habbema

doi:10.1002/ijc.22167

Monitoring a national cancer prevention program: successful changes in cervical cancer screening in the Netherlands

Matejka Rebolj, Marjolein van Ballegooijen, Louise-Maria Berkers, Dik Habbema

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

93 Citationer (Scopus)

Abstract

Udgivelsesdato: 2007-Feb-15

Originalsprog	Engelsk
Tidsskrift	International Journal of Cancer
Vol/bind	120
Udgave nummer	4
Sider (fra-til)	806-12
Antal sider	6
ISSN	0020-7136
DOI	https://doi.org/10.1002/ijc.22167
Status	Udgivet - 2007
Udgivet eksternt	Ja

Bibliografisk note

Keywords: Adult; Cervix Uteri; Cytodiagnosis; Female; Follow-Up Studies; Health Plan Implementation; Humans; Mass Screening; Middle Aged; National Health Programs; Netherlands; Practice Guidelines as Topic; Precancerous Conditions; Program Evaluation; Referral and Consultation; Uterine Cervical Neoplasms; Vaginal Smears

Adgang til dokumentet

10.1002/ijc.22167

Citationsformater

@article{7089afc0873d11de8bc9000ea68e967b,

title = "Monitoring a national cancer prevention program: successful changes in cervical cancer screening in the Netherlands",

abstract = "The success of screening, an important cancer prevention tool, depends on the quality and efficiency of protocols and guidelines for screening and follow-up. However, even centrally organized screening programs such as the Dutch cervical screening program occasionally show problems in performance. To improve this program, the screening scheme, follow-up, administration and financing protocols and guidelines were thoroughly changed in 1996. This study evaluates the consequences for the performance of the national program. Five-year coverage rate, the proportion of screened women sent to follow-up, follow-up compliance and duration, and the yearly number of Pap smears before and after the changes in 1996 were compared. Five-year coverage increased substantially in the added target age groups (30-34, and 54-60 years); in the old target age group (35-53 years) it remained around 80%. The percentage of screened women sent to follow-up decreased from almost 19-3% per screening round, due to a more restrictive use of the Pap 2 classification, and an evidence-based cessation of follow-up of negative smears without endocervical cells. Follow-up compliance has improved, and the average time until a woman is either referred or rejoins the regular screening schedule, has become shorter. The total number of smears, a strong determinant of screening costs, has decreased by 20% primarily due to the changed follow-up recommendations. In conclusion, the 1996 changes in protocols and guidelines, and their implementation have increased coverage and efficiency, and decreased the screening-induced negative side effects.",

author = "Matejka Rebolj and {van Ballegooijen}, Marjolein and Louise-Maria Berkers and Dik Habbema",

note = "Keywords: Adult; Cervix Uteri; Cytodiagnosis; Female; Follow-Up Studies; Health Plan Implementation; Humans; Mass Screening; Middle Aged; National Health Programs; Netherlands; Practice Guidelines as Topic; Precancerous Conditions; Program Evaluation; Referral and Consultation; Uterine Cervical Neoplasms; Vaginal Smears",

year = "2007",

doi = "10.1002/ijc.22167",

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AU - Rebolj, Matejka

AU - van Ballegooijen, Marjolein

AU - Berkers, Louise-Maria

AU - Habbema, Dik

N1 - Keywords: Adult; Cervix Uteri; Cytodiagnosis; Female; Follow-Up Studies; Health Plan Implementation; Humans; Mass Screening; Middle Aged; National Health Programs; Netherlands; Practice Guidelines as Topic; Precancerous Conditions; Program Evaluation; Referral and Consultation; Uterine Cervical Neoplasms; Vaginal Smears

PY - 2007

Y1 - 2007

N2 - The success of screening, an important cancer prevention tool, depends on the quality and efficiency of protocols and guidelines for screening and follow-up. However, even centrally organized screening programs such as the Dutch cervical screening program occasionally show problems in performance. To improve this program, the screening scheme, follow-up, administration and financing protocols and guidelines were thoroughly changed in 1996. This study evaluates the consequences for the performance of the national program. Five-year coverage rate, the proportion of screened women sent to follow-up, follow-up compliance and duration, and the yearly number of Pap smears before and after the changes in 1996 were compared. Five-year coverage increased substantially in the added target age groups (30-34, and 54-60 years); in the old target age group (35-53 years) it remained around 80%. The percentage of screened women sent to follow-up decreased from almost 19-3% per screening round, due to a more restrictive use of the Pap 2 classification, and an evidence-based cessation of follow-up of negative smears without endocervical cells. Follow-up compliance has improved, and the average time until a woman is either referred or rejoins the regular screening schedule, has become shorter. The total number of smears, a strong determinant of screening costs, has decreased by 20% primarily due to the changed follow-up recommendations. In conclusion, the 1996 changes in protocols and guidelines, and their implementation have increased coverage and efficiency, and decreased the screening-induced negative side effects.

AB - The success of screening, an important cancer prevention tool, depends on the quality and efficiency of protocols and guidelines for screening and follow-up. However, even centrally organized screening programs such as the Dutch cervical screening program occasionally show problems in performance. To improve this program, the screening scheme, follow-up, administration and financing protocols and guidelines were thoroughly changed in 1996. This study evaluates the consequences for the performance of the national program. Five-year coverage rate, the proportion of screened women sent to follow-up, follow-up compliance and duration, and the yearly number of Pap smears before and after the changes in 1996 were compared. Five-year coverage increased substantially in the added target age groups (30-34, and 54-60 years); in the old target age group (35-53 years) it remained around 80%. The percentage of screened women sent to follow-up decreased from almost 19-3% per screening round, due to a more restrictive use of the Pap 2 classification, and an evidence-based cessation of follow-up of negative smears without endocervical cells. Follow-up compliance has improved, and the average time until a woman is either referred or rejoins the regular screening schedule, has become shorter. The total number of smears, a strong determinant of screening costs, has decreased by 20% primarily due to the changed follow-up recommendations. In conclusion, the 1996 changes in protocols and guidelines, and their implementation have increased coverage and efficiency, and decreased the screening-induced negative side effects.

U2 - 10.1002/ijc.22167

DO - 10.1002/ijc.22167

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JO - International Journal of Cancer

JF - International Journal of Cancer

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ER -