Cervical screening in England: the past, present, and future.

Area of Science:

• Public Health
• Gynecologic Oncology
• Screening Programs

Background:

• Cervical screening in England began in 1964 but faced challenges, leading to the establishment of the National Health Service Cervical Screening Programme (NHSCSP) in the mid-1980s.
• The NHSCSP is characterized by its population-based registry, systematic call-and-recall process, national coordination, and quality assurance.

Purpose of the Study:

• To review the evolution and current status of the NHSCSP.
• To identify key developments and future challenges in cervical cancer screening.

Main Methods:

• The NHSCSP has progressively integrated technological advancements, including liquid-based cytology and high-risk human papillomavirus (HR-HPV) testing.
• Current protocols involve primary cytology with HPV triage for low-grade abnormalities and HR-HPV testing for treatment follow-up.

Main Results:

• The program has adapted to new evidence, notably incorporating HPV testing into its strategy.
• Developments between 2000-2010 included liquid-based cytology, reflex HR-HPV testing, and automation potential.

Conclusions:

• The NHSCSP demonstrates adaptability based on scientific evidence.
• Future challenges include increasing screening uptake in younger women and transitioning to HPV primary screening.