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Implementation of human papillomavirus testing in cervical screening without a concomitant decrease in participation rate
  1. N W J Bulkmans1,*,
  2. S Bulk1,*,
  3. M S Ottevanger1,
  4. L Rozendaal1,
  5. S M Hellenberg2,
  6. F J van Kemenade2,
  7. P J F Snijders1,
  8. A J P Boeke3,
  9. C J L M Meijer1
  1. 1Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
  2. 2ScreeningsOrganisatie Bevolkingsonderzoek Baarmoederhalskanker Noord-Holland & Flevoland, GGD Amstelveen, Amstelveen, The Netherlands
  3. 3Department of General Practice, Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to:
    C J L M Meijer
    Department of Pathology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands; cjlm.meijer{at}


Adding high-risk human papillomavirus (hrHPV) testing to screening increases the efficacy of cervical screening programmes. However, hrHPV testing may result in a lower participation rate because of the perceived association with sexually transmitted infections. We describe how testing for hrHPV was added to cervical screening in the POpulation-BAsed SCreening study AMsterdam (POBASCAM) trial. Participation rates of the screening programme before and after hrHPV implementation were evaluated in the region where the POBASCAM trial was carried out. The participation rate was 58.7% before and 61.4% after the addition of hrHPV testing to screening (p<0.001). An inventory of frequently asked questions is presented. Thus, hrHPV testing can be added to cervical screening by cytology without a decrease in participation rate.

  • hrHPV, high-risk human papillomavirus
  • POBASCAM, POpulation-BAsed SCreening study AMsterdam

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  • * Both authors contributed equally to this manuscript.

  • Patient consent has been obtained for publication of this study.

    Funding: This work was supported by grant 30-522 from the Health Research & Development Council of The Netherlands (ZonMw, formerly the Praeventiefonds).

  • Competing interests: None.

  • Ethical approval: This study was approved by the medical ethics committee of the VU University Medical Center, Amsterdam, The Netherlands (number 96/103A), and by the Ministry of Public Health, The Hague, The Netherlands (VWS number 328 650).