Cervical cancer screening adherence across Europe: between long‑term increases and recent decreases

Background

Cervical cancer screening is a fundamental tool for oncological prevention. The COVID-19 pandemic caused significant disruptions to screening programmes across Europe, potentially affecting coverage of the target population. This study analyzes the trends of cancer screening adherence from 2000 to 2024 across European countries, with a specific focus on the impact of the pandemic.

Methods

Data on cervical cancer screening adherence from EU and EFTA countries were collected from Eurostat database. Overall, twelve countries have at least ≥15 years of data (8 from 2000 to 2023 and 4 from 2000 to 2024). Joinpoint regression was used to analyze trends by the identification of the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) over time.

Results

In the last year available, Norway, Finland, Sweden and Slovenia reported the highest coverage (>70%), while Hungary and Italy recorded the lowest values (<45%). The pandemic impact is evident most of the countries, with significant declines observed around 2020–2021, especially in Latvia (-14,86%), Slovakia (-12,81%), the Netherlands (-11,51%) and Italy (-11,17%). Most countries show post-pandemic recovery trends, with the strongest rebounds in Slovakia (significant APC 2021–2023: +10.49), Estonia (significant APC 2020–2023: +6.03) and Hungary (significant APC 2021–2024: +3.40). The Netherlands represent an exception, where the decline appears structural and predates the pandemic (significant APC 2014–2023: −2.04).

Conclusions

Marked disparities between countries are reported during the study period, highlighting the need for targeted interventions to support organized and coordinated screening programmes, particularly in contexts with structurally low uptake or long-term declining trends. The COVID-19 pandemic led to a reduction in cervical screening coverage across most European countries analyzed, with recovery generally beginning from 2021.

Key messages

• Analyzing trends in cervical cancer screening uptake provides crucial insights for public health planning, particularly in understanding the impact of major disruptive events.

• COVID-19 caused varying impacts on cervical cancer screening trends across European countries; understanding health system responses is key to strengthening resilience of screening programs.