Recent Developments in the Dutch Cervical Cancer Screening Programme

Abstract

Worldwide, cervical cancer is the second most common female malignancy, diagnosed in 500,000 women each year, while 275,000 die from it. Without prevention, the peak incidence occurs at a relatively young age, between 40-55 years, when women are still active on the labour market and have young children. While cervical cancer is the leading cancer-related cause of death and the second most common cancer in women in developing countries (incidence rates ≥30 per 100,000), it became much less common in developed countries in the recent decades. In the Netherlands, the incidence and mortality have been decreasing for decades (Figure 1-1). In 2003, cervical cancer was newly diagnosed in 584 women (World standardized incidence rate (WSR): 4.9 per 100,000 women) and 214 women died from it (WSR: 1.4 per 100,000 women). Inter-country differences in cervical cancer incidence are caused by differences in determinants and in access to preventive measures. The prevalence of the Human Papillomavirus (HPV) infection, the necessary factor in the development of cervical cancer, is generally higher in developing countries. Differences in the host factor, e.g. more common malnourishment and the prevalence of other infections in the developing countries, may also play a role. These countries typically do not offer population-wide cervical cancer screening facilities, which require a high level of organization and adequate health care resources