title: Screening of cervical cancer in Catalonia 2006-2012.
abstract: The early detection of intraepithelial lesions of the cervix, through the periodic examination of cervical cells, has been fundamental for the prevention of invasive cervical cancer and its related mortality. In this report, we summarise the cervical cancer screening activities carried out in Catalonia, Spain, within the National Health System during 2008-2011. The study population covers over two million women resident in the area. The evaluation includes 758,690 cervical cytologies performed on a total of 595,868 women. The three-year coverage of cervical cytology among women aged between 25 and 65 years was 40.8%. About 50% of first screened women with negative results had not returned to the second screening round. The introduction of high-risk human papillomavirus DNA (HPV) detection, as a primary screening cotest with cytology among women over age 40 with a poor screening history, significantly improved the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), being far superior to cytology alone. Cotesting did not improve the detection of CIN2+. The use of the HPV test for the triage of atypical squamous cell undetermined significance (ASC-US) improved the selection of women at high risk of CIN2+. Sampling (both cytology and HPV test) was largely performed by midwives (66.7%), followed by obstetricians (23.8%) and nurses (7%). Over half of the centres (54.8%) had full use of online medical records. During the study period, educational activities for professionals and for women were carried out periodically. The organisation of screening as a population activity in which women are actively called to the screening visit and the introduction of HPV testing as a primary screening tool are strongly recommended to ensure the maximum population impact in the reduction of the cervical cancer burden.
authors.affiliation: Cancer Epidemiology Research Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, 08907, Spain ; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona 08036, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: de Sanjosé
authors.affiliation: Cancer Epidemiology Research Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, 08907, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Ibáñez
authors.affiliation: Cancer Epidemiology Research Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, 08907, Spain.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Rodríguez-Salés
authors.affiliation: Cancer Epidemiology Research Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, 08907, Spain.
authors.forename: Mercè
authors.initials: M
authors.lastname: Peris
authors.affiliation: Cancer Epidemiology Research Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, 08907, Spain ; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona 08036, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Roura
authors.affiliation: Cancer Epidemiology Research Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, 08907, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Diaz
authors.affiliation: Instituto Clínico de Ginecología, Obstetricia y Neonatología, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Facultad de Medicina, Universidad de Barcelona, Barcelona 08036, Spain.
authors.forename: Aureli
authors.initials: A
authors.lastname: Torné
authors.affiliation: Coordinación Maternoinfantil y Atención a la Salud Sexual y Reproductiva, Institut Català de la Salut, Bacelona 08007, Spain.
authors.forename: Dolors
authors.initials: D
authors.lastname: Costa
authors.affiliation: Corporació Sanitària Parc Taulí, Sabadell 08208, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Canet
authors.affiliation: Atención a la Salud Sexual y Reproductiva (ASSIR) Vallès Oriental y Occidental, Dirección de Atención Primaria, Gerencia Territorial Metropolitana Norte, Institut Català de la Salut, Sabadell, Barcelona 08202, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Falguera
authors.affiliation: Consorci Sanitari Integral, Hospital General de l'Hospitalet, L'Hospitalet de Llobregat, Barcelona 08906, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Alejo
authors.affiliation: Unidad de Registro de Cáncer de Cataluña, Departamento de Salud, Autoridad Regional de Cataluña, L'Hospitalet de Llobregat, Barcelona 08907, Spain.
authors.forename: Josep Alfons
authors.initials: JA
authors.lastname: Espinàs
authors.affiliation: Cancer Epidemiology Research Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, 08907, Spain.
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Bosch
keywords: HPV; cervical cancer; coverage; screening