CervicalScreen Norway – A screening programme in transition

Abstract

An organised screening programme for cervical cancer (CervicalScreen Norway) was implemented in Norway in 1995. The overall aim of the programme is to reduce the incidence and mortality of cervical cancer, and the screening coverage should exceed 80%. Women in the target age group (25-69 years) are invited for screening every third or fifth year depending on whether the primary screening test is a cytology smear or an HPV (human papillomavirus) test. Since the initiation, there have been major changes within the programme and HPV testing has become increasingly important. The primary screening test has changed from cytology for the whole target age group to primary HPV testing for women from the age of 34, HPV genotype information is directing the follow-up of women in the screening algorithm, and HPV self-sampling will be implemented to increase attendance in under-screened women. CervicalScreen Norway has had a significant impact on reducing the incidence and mortality of the disease. Nevertheless, there has been an increase in incidence in Norway the last decade, in particular among young women. In 2018, the WHO Director-General announced an ambitious global call for action to eliminate cervical cancer through vaccination, screening and treatment. CervicalScreen Norway supports the ambition of the WHO and is working towards this goal.