'Organised' cervical screening 45 years on: How consistent are organised screening practices?

Area of Science:

• Public Health
• Oncology
• Preventive Medicine

Background:

• Organised screening programmes significantly reduce cervical cancer incidence and mortality.
• Opportunistic screening for cervical cancer shows variable effectiveness.
• Current expert recommendations favor organised programmes for cervical screening and HPV testing.

Purpose of the Study:

• To define what constitutes an 'organised' cervical screening programme.
• To determine the role and place of opportunistic screening within organised programmes.
• To analyze the practical application versus the formal definition of organised cervical screening.

Main Methods:

• Systematic review of 154 peer-reviewed papers.
• Analysis of literature on organised and opportunistic cervical screening approaches.
• Published between 1970 and 2014.

Main Results:

• The term 'organised' in cervical screening lacks a clear, consistent definition in practice, despite a recognized formal definition.
• Observed organised programmes often deviate from prescribed norms and from each other.
• Significant intersections and overlaps exist between opportunistic and organised screening approaches.

Conclusions:

• There is a need to better understand the practical variations in organised cervical screening programmes.
• Further research should investigate the drivers and impacts of opportunistic screening on population outcomes.
• Appreciating the complexity of screening programmes is vital for adapting to new technologies, evidence, and a vaccinated population.