The Dutch primary HPV-based cervical cancer screening programme: Evaluation and improvements

The Dutch cervical cancer screening programme is under constant evaluation and improvements are regularly made. In 2017, the nation-wide programme was restructured to use primary HPV-testing instead of primary cytology. This thesis uses data-analysis to evaluate the attendance rate and the effect of introducing HPV self-sampling. Additionally, it uses simulation model MISCAN-Cervix to investigate opportunities for improvements to the programme, such as for the self-sampling deployment strategy, the triage method and the starting and ending ages of screening. Finally, it investigates the long-term consequences of Covid for the effects of the screening programme and it explores the possible timing of elimination of cervical cancer without deteriorating the harms-benefits ratio of screening.