Cervical cancer screening programmes that limit tests to women aged 30-60 years are missing a significant proportion of women who are at risk of getting the disease. An analysis of 401 cases of cervical cancer diagnosed in the Netherlands, where screening is only offered to women aged 30-60, has shown that 19% were in women aged under 30 and 12% were in women over 60.

The analysis, reported by Dr Roosmarie de Bie at the 16th International Meeting of the European Society of Gynaecological Oncology (ESGO) in Belgrade, Serbia, 11-14 October 2009, also showed that 40% of cervical cancer cases were in women who had regular screening tests, and 25% had a normal smear within the five years before their diagnosis, suggesting a need for more sensitive tests.

Dr de Bie, from Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands, concluded that underscreening together with insufficient sensitivity are the main problems of the national screening programme, and its effectiveness can be improved by interventions to increase the participation rate and the sensitivity of the screening test. She recommended that the target age-range of the current programme should be re-evaluated.

Dr de Bie also told delegates that a project underway in Nijmegen is piloting the use of home HPV DNA tests in an effort to reach more women who are currently missing out on conventional smear tests.

Currently in the Netherlands, there are 600 new cases of cervical cancer each year despite the presence of an established national screening programme.