Cervical cancer screening (Indicator 25)
Updated
The indicator describes the following: Proportion of women between the ages of 25 and 69 screened for cervical cancer under a national screening programme at least once, or more often.
This indicator is part of Target (9): Essential medicines and basic technologies for the treatment of serious non-communicable diseases.
Women are recommended to undergo screening for precancerous changes in connection with cervical cancer every third year for women between 25-33 years, and every 5 years for women between 34-69 years. Previously, national recommendations were cytology screening every three years for the entire target group, but the recommendation was changed in autumn 2017 based on international results from randomised studies and data from a Norwegian pilot carried out in three test counties. National implementation started in January 2019 and was completed in March 2022. The indicator describes the proportion of women screened within 3.5 years. The change in the recommended screening interval creates challenges when calculating the indicator, as more and more women will be advised to wait five years before the next screening test with a normal test result. This will result in a decrease in the coverage rate of 3.5 years, which does not reflect a decrease in support for the programme. Women between the ages of 34 and 69 and living in the sample counties are not included in the calculation of the 3.5-year coverage rate as all the women in those counties have a recommended screening interval of 5 years.
Breast cancer screening is not included as an NCD indicator.
Results
- In the target group for the Cervical Screening Programme, women aged 25-69, the coverage level for screening within 3.5 years was 7 per cent in 2021.
- A weak declining trend was observed from 2004 to 2014, but from 2015 there has been a weak increasing trend, especially among the youngest women.
|
Ages 25–33 |
Ages 34–54 |
Ages 55–69 |
Ages 25–69 |
|
|
1994 |
81 |
73 |
46 |
68 |
|
1995 |
83 |
76 |
53 |
72 |
|
1996 |
83 |
77 |
58 |
74 |
|
1997 |
82 |
77 |
61 |
75 |
|
1998 |
81 |
78 |
65 |
76 |
|
1999 |
81 |
79 |
67 |
76 |
|
2000 |
79 |
78 |
68 |
76 |
|
2001 |
78 |
77 |
69 |
75 |
|
2002 |
78 |
78 |
72 |
77 |
|
2003 |
77 |
79 |
74 |
77 |
|
2004 |
77 |
79 |
74 |
78 |
|
2005 |
75 |
78 |
73 |
76 |
|
2006 |
73 |
78 |
73 |
75 |
|
2007 |
71 |
77 |
72 |
74 |
|
2008 |
69 |
76 |
72 |
74 |
|
2009 |
68 |
75 |
71 |
73 |
|
2010 |
66 |
74 |
70 |
71 |
|
2011 |
65 |
73 |
71 |
71 |
|
2012 |
64 |
72 |
70 |
70 |
|
2013 |
63 |
71 |
69 |
69 |
|
2014 |
63 |
71 |
68 |
68 |
|
2015 |
65 |
72 |
69 |
69 |
|
2016 |
67 |
72 |
69 |
70 |
|
2017 |
69 |
74 |
69 |
71 |
|
2018 |
70 |
73 |
69 |
71 |
|
2019 |
69 |
74 |
69 |
72 |
|
2020 |
68 |
73 |
68 |
70 |
|
2021 |
70 |
74 |
69 |
71 |
Data source: Cancer Registry of Norway
The data source for this indicator is the annual report by the Cervical Screening Programme. A description and definitions follow below.
Description
The Cancer Registry of Norway manages the national screening programme in which women between the ages of 25 and 69 receive letters reminding them to visit their GP or midwife for a cervical smear test two months before the recommended time for a new test, i.e., 2 years and 10 months or 4 years and 10 months after a normal smear test result. The Cervical Cancer Screening Programme has been nationwide since 1995 and an annual report is published.
- The Norwegian Cancer Registry
- Cervical cancer screening
- Annual reports from the Cervical Cancer Screening Programme
Effect measure
3.5-year coverage level as a percentage. This describes the proportion of women who have undergone at least one smear test during the last 3.5 years.
The level of coverage is calculated from the base population minus those individuals who have had gynaecological cancer or whose cervix was removed for other reasons. The structure of the Norwegian Cervical Cancer Screening Programme requires women to proactively make an appointment at their doctor and yearly reminders are sent out where there is no record of a cervical smear test. For this reason, the level of coverage is defined as the number of women who have undergone at least one smear test during a time period. We report coverage levels of over 3.5 years.
The calculations take as their starting point all women registered in the National Population Register as of 31st December at the end of the period, after which investigation takes place into whether these women reported at least one cervical smear test (or, where appropriate, HPV test as a primary test) in the last 3.5 years.
Global indicator definition
Indicator 25. Proportion of women between the ages of 30 and 49 screened for cervical cancer at least once, or more often, and for lower or higher age groups according to national programmes or policies.
National adaptation
In Norway, all women between 25 and 69 years of age are screened. This is a wider age range than in WHO’s indicator definition.