PhD Defence Clare Aitken

Organised cervical cancer screening has been offered in the Netherlands for more than thirty years. A major reorganisation of the Dutch cervical cancer screening programme took place in 2017. The primary screening test changed from cervical cytology to high-risk human papillomavirus (hrHPV) testing. Other policy and organisational changes were implemented alongside with change in the test. Monitoring and evaluation are essential for assessing the impact of these changes on the quality of the programme. Therefore, this thesis aimed to evaluate the Dutch cervical cancer screening programme as a whole, as well as each stage of the screening process – attendance, test and referral and clinical care –with a particular focus on the transition from cytology-based screening to hrHPV-based screening.