[Cervical cancer screening in Germany].

Area of Science:

• Oncology
• Public Health
• Gynecology

Background:

• Cytological examination for cervical cancer (CCS) has been available in Germany since 1971, with annual Pap smears offered to women over 20.
• Despite a historical decline in cervical carcinoma incidence post-CCS introduction, recent years have seen stagnation.
• Persistent high-risk human papillomavirus (HPV) infection is the primary cause of cervical cancer, with HPV testing and vaccination as key prevention strategies.

Purpose of the Study:

• To implement an organized nationwide cervical cancer screening program in Germany, aligning with the European Guideline for Cervical Cancer Screening.
• To update screening protocols based on advancements in HPV testing and vaccination.
• To improve early detection and prevention of cervical cancer through a structured national program.

Main Methods:

• The Federal Joint Committee (G-BA) updated key points for an organized nationwide screening program in April 2018.
• Annual cytological screening (Pap smear) will continue for women aged 20-34.
• Women aged 34 and older will undergo co-testing (Pap smear and HPV test) every three years.

Main Results:

• The new program integrates co-testing with HPV tests for women over 34, replacing annual Pap smears for this age group.
• An organized screening program with personal invitations and information leaflets will be implemented.
• The program includes a plan for evaluation after a minimum six-year test phase.

Conclusions:

• The updated screening program aims to enhance early detection of cervical cancer by incorporating HPV co-testing for women over 34.
• The implementation of an organized nationwide program signifies a shift towards a more proactive approach to cervical cancer prevention in Germany.
• Long-term evaluation will be crucial to assess the effectiveness of the new screening strategy in reducing cervical cancer incidence and mortality.