Should we continue population-based cervical cancer screening programme in Poland? A statement in favour

Abstract

Organised cervical cancer screening programme in Poland introduced in 2006/2007 has never been optimal, largely due to low participation rate. However, recent analysis of trends in the burden of cervical cancer mortality revealed an acceleration of the downward trends in women of the screening age 25–59 around the time of the introduction of the programme. Possible factors responsible for this phenomenon include dissemination of Pap testing (mainly in opportunistic screening) and attempts to assure higher quality of screening procedures, which accompanied the roll-out of the screening programme. Despite the obvious flaws and limitations of the programme, its discontinu­ation might result in adverse epidemiological, clinical and financial outcomes related to limiting the screening to the opportunistic mode only. Therefore the programme requires continuation and improvements. Unfavourable trends in the burden of the disease in older women require rising the upper age limit for screening to facilitate access to screening. Several strategies to raise participation need to be tested. The inevitable advent of more sensitive but less specific, molecular HPV screening requires pilot studies, evaluation of their outcomes and adjustments before full-scale introduction at the national level. According to European Guidelines, this may be executed only within an organised screening programme.