CERVICAL SCREENING IN ENGLAND: LIQUID-BASED CYTOLOGY IN THE CONTEXT OF MODERNIZATION OF THE NHS CERVICAL SCREENING PROGRAMME

摘要

The article will briefly explain the processes of organized screening in the NHS Cervical Screening Programme (NHSCP). Quality control is well established and monitored by regional quality assurance reference centres. The final outcome of screening is also monitored by national cervical cancer mortality and incidence rates: data will be presented for rates of in situ and invasive cervical carcinoma before and after the introduction of organized screening. The NHSCSP is using the introduction of liquid-based cytology as a platform for modernization, which is planned to include high-risk human papillomavirus (HR HPV)testing for low-grade cytology triage as well as a test of cure after treatment. Trials of computer-assisted screening are also in progress. High standards of quality control will be needed in the era of vaccination, when prevalence of preinvasive and invasive cervical cancer will decline. The NHSCSP is well placed to take on these challenges, if necessary by introducing primary HR HPV testing so that cytology screening can be concentrated on women who are genuinely at risk.