Indicators for Non-Communicable Diseases (NCD)

Cervical cancer screening (Indicator 25)

Published 13.12.2018 Updated 08.01.2020

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.

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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. The indicator describes the proportion of women screened within 3.5 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 70 per cent in 2018.
A weak declining trend has been observed since 2004, but it appears that the trend has now been reversed, especially among the youngest women.

Figure 1. Coverage level for screening as part of the Cervical Screening Programme within 3.5 years, in 15-year age groups, as a percentage, 1994-2018. Source: The National Population Register and the Cytology/HPV Registries at the Norwegian Cancer Registry. See table below.

Table accompanying Figure 1

Table 1. Coverage level for screening as part of the Cervical Screening Programme within 3.5 years, in 15-year age groups, as a percentage, 1994-2018. Source: National Population Register and the Cytology/HPV Registries at the Cancer Registry of Norway.
	Ages 25–39	Ages 40–54	Ages 55–69	Ages 25–69
1994	72	68	46	65
1995	74	71	53	68
1996	74	73	58	70
1997	74	73	60	70
1998	73	74	63	71
1999	73	75	65	72
2000	72	74	65	71
2001	72	74	65	71
2002	72	75	68	72
2003	71	75	69	72
2004	71	75	70	72
2005	70	74	69	71
2006	68	73	69	70
2007	67	73	68	69
2008	66	73	68	69
2009	65	72	68	68
2010	64	71	67	67
2011	63	71	67	67
2012	62	70	67	66
2013	63	70	66	66
2014	63	70	66	66
2015	65	71	67	68
2016	67	72	67	69
2017	68	72	68	70
2018	70	72	67	70

Data source: Cancer Registry of Norway

The data source for this indicator is the annual report by the Cervical Screening Programme and data from the Cytology/HPV Registries, both at the Cancer Registry of Norway. 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 for a cervical smear test every third year. The Cervical Cancer Screening Programme has been nationwide since 1995 and an annual report is published.

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 contact their doctor and reminders are sent out where there is no record of a cervical smear test after three or four years. For this reason, the level of coverage is defined as the number of women who have undergone at least one smear test during the course of one 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 time 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) 3.5 years earlier.

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.

History

Authors and contacts

Text compiled by the Cervical Cancer Screening Programmeat the Norwegian Cancer Registry and the Department of Chronic Diseases and Ageing at the Norwegian Institute of Public Health.