Assessment and Management of Cervical Cancer Screening Programs in Japan

In recent years, the implementation of HPV test as a new modality of cervical cancer screening has been discussed in Japan. Cancer screening, however, does not mean simply a screening test for examinees, but a series of programs conducted for a large population of subjects, including post-test medical treatment, follow-up management, and monitoring of the outcome of the screening. Although the choice of effective screening modality is important, its role is only a small part of the screening program. Meanwhile, evaluating the operation of the screening program and repeatedly improving it is a major part of the program and leads to minimizing the harms to the examinees while ensuring the effectiveness of cancer screening. The importance of quality control of screening (management), which evaluates and improves the operation of cancer screening, needs to be clearly distinguished from that of efficacy evaluation (assessment), which uses mortality reduction effects to select test modality. Here, we present information on the current status of population-based screening in Japan and outline the concept of quality control of cancer screening, including its relationship to assessment of the efficacy of cancer screening.