The Norwegian Department of Health and Social Affairs initiated a national screening program for cervical cancer in 1990, with all women aged 25 to 70 years to be offered cervical screening every three years. During the first three years of the program (November 1991–October 1994), all spontaneous cervical cytology in Norway was recorded at the Norwegian Cancer Registry. In addition, women in the counties of Vestfold and Sør-Trøndelag were invited individually to be screened. The aim of the present study was principally to evaluate the organizational aspects of a nationwide, population-based screening program for cervical cancer in Norway. Special attention was paid to the coverage, the attendance rate, and the cytologic findings in the two-county study area. A total of 1,581,379 Pap smears were recorded from November 1991 to October 1994. Most smears were taken from women under age 30 years (31.7 percent). About 25 percent of the women aged 25 to 29 years had more than one normal smear. In the study area, a coverage of about 71 percent in the age group 25 to 69 years was achieved. The pilot project also has shown that it is possible to recruit elderly women into screening. However, no difference was noted between the study and the reference area with regard to findings per smear of precursor lesions (CIN 3, modified SNOMED coding system). The experiences from three years of recording and the implementation of the pilot project have provided useful guidelines for the national screening which began in January 1995.
Similar content being viewed by others
References
Cancer Registry of Norway. Cancer in Norway 1992. Oslo, Norway: Cancer Registry, 1995.
Central Bureau of Statistics. Causes of Death 1992. Main Tables. NOS C155. Oslo-Kongsvinger, Norway: 1994.
Bjørge T, Thoresen SØ, Skare GB. Incidence, survival and mortality in cervical cancer in Norway, 1956–90. Eur J Cancer 1993; 29A: 2291–7.
Hakama M, Magnus K, Pettersson F, Storm H, Tulinius H. Effect of organized screening on the risk of cervical cancer in the Nordic countries. In: Miller AB, Chamberlain J, Day NE, Hakama M, Prorok PC, eds. Cancer Screening. UICC Project on Evaluation of Screening for Cancer, Cambridge, UK: International Union Against Cancer; 1991: 153–62.
Miller AB, Chamberlain J, Day NE, Hakama M, Prorok PC. Report on a workshop of the UICC project on evaluation of screening for cancer. Int J Cancer 1990; 46: 761–9.
Hakama M, Miller AB, Day NE, eds Screening for Cancer of the Uterine Cervix Lyon, France: International Agency for Research on Cancer, 1986; IARC Sci. Pub. No. 76.
Coleman D, Day N, Douglas G, et al. European guidelines for quality assurance in cervical cancer screening. Eur J Cancer 1993; 29A (Suppl. 4): 1–38.
Hakama M. Potential contribution of screening to cancer mortality reduction. Cancer Detect Prev 1993; 17: 513–20.
Magnus K, Langmark F, Andersen A. Mass screening for cervical cancer in Østfold county of Norway 1959–77. Int J Cancer 1987; 39: 311–6.
Bjørge T, Gunbjørud AB, Langmark F, Skare GB, Thoresen SØ. Cervical mass screening in Norway—510,000 smears a year. Cancer Detect Prev 1994; 18: 463–70.
Norges offentlige utredninger. Masseundersøkelsen for kreft i livmorhalsen (in Norwegian). Oslo, Norway: Universitetsforlaget, 1987; NOU 1987: 8 (Green Paper).
Côté RA, ed. Systematized Nomenclature of Medicine (SNOMED). Skokie, Illinois (USA): College of American Pathologists, 1979.
Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53:457–81.
Forsmo S, Buhaug H, Stalsberg H. Use of pap-smears in a population without a mass screening program. Acta Obstet Gynecol Scand 1994; 73: 824–8.
Pontén J, Adami HO, Bergström R, et al. Strategies for global control of cervical cancer. Int J Cancer 1995; 60: 1–26.
Adami HO, Pontén J, Sparén J, Bergström R, Gustafssen L, Friberg LG. Survival trend after invasive cervical cancer diagnosis in Sweden before and after cytological screening. Cancer 1994; 73: 140–7.
Läärä E, Day NE, Hakama M. Trends in mortality from cervical cancer in the Nordic countries: association with organized screening programmes. Lancet 1987; 1: 1247–9.
Wøien G. Masseundersøkelsen mot Livmorbalskreft. Evaluering av Informasjonsvirksombeten (in Norwegian). Oslo, Norway: 1994.
Cook GA, Draper GJ. Trends in cervical cancer and carcinoma in situ in Great Britain. Br J Cancer 1984; 50: 367–75.
Bosch FX, Muñoz N, Shah KV, Meheus A. Second international workshop on the epidemiology of cervical cancer and human papillomavirus. Int J Cancer 1992; 52: 171–3.
Beral V, Day NE. Screening for cervical cancer: Is there a place for incorporating tests for the human papillomavirus? In: Muñoz N, Bosch FX, Shah KV, Meheus A, eds. The Epidemiology of Human Papillomavirus and Cervical Cancer. Lyon, France: International Agency for Research on Cancer, 1992; IARC Sci. Pub. No. 119: 263–9.
Author information
Authors and Affiliations
Additional information
This work was funded by grant no. 95034/001 from the Norwegian Cancer Society.
Rights and permissions
About this article
Cite this article
Bjørge, T., Gunbjørud, A.B., Haugen, O.A. et al. Mass screening for cervical cancer in Norway: evaluation of the pilot project. Cancer Causes Control 6, 477–484 (1995). https://doi.org/10.1007/BF00054154
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00054154