Professional paper
Cervical Cancer Screening Programme in Finland with an Example on Implementing Alternative Screening Methods
Ahti Anttila
Pekka Nieminen
Abstract
In Finland (population 5 million) the organised Pap screening programme for preventing cervical cancer has been in
action already for 45 years. Women aged 30 to 64 are targeted (N 1.25 million) and the screening interval is five years.
The programme invites women seven times in a lifetime; the attendance rate per one screening invitational round is 73%.
The programme has affected markedly the cervical cancer rates in our country. During the decennia of its action there
has been about 80% decrease in the age-adjusted cervical cancer incidence and mortality rates. The current age-standardised
incidence rate is 4 and mortality rate 1 per 100,000 woman-years. In the current article we describe the organisational
aspects of the programme; and pay attention to renovation of the programme taken place during the last decade
when novel technological alternatives have been started to be used as the screening tests. By expanding the coverage and
compliance of screening we still expect to increase the impact of the programme. Same time, efforts are needed to avoid
overuse of services due to spontaneous screening, in order to decrease potential adverse effects and improve overall costeffectiveness.
A large-scale public health policy trial on Human papillomavirus (HPV) screening is on-going. Cross-sectional
information available thus far suggests promising results. Follow-up of cancer rates after screening episodes are
still required to evaluate optimal screening policies (e.g., screening intervals by age groups, and starting and stopping
ages). We propose speeding up the use of modern technological alternatives in organised screening programmes.
Keywords
Cervical cancer; incidence; mortality; organised screening; effectiveness; cytological screening; HPV-DNA screening
Hrčak ID:
27436
URI
Publication date:
13.4.2007.
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