Monitoring and evaluation

Examination coverage

A BRIEF SUMMARY: During the 2021–2024 period, examination coverage again exceeded the 70% target, reaching 72.5% nationwide. This is a decrease of 2 percentage points compared to the previous 3-year period, when the highest screening rate was recorded. The decrease was expected and is due to the accumulation of a higher number of screenings in the aftermath of the lifting of the COVID-19 pandemic measures (explained below). There are differences in screening rates by age and by the location of residence of women. Screening rates are low among older women (55-64 years), and lowest in the south-west, north-east and in north-western part of the country.

This subpage shows the results of the 3-year examination coverge of the target population in the NP ZORA – the percentage of women, aged 20 to 64, who had at least one Pap smear during the observed 3-year period. The women who have a Pap smear test result are included in the numerator of the equation, while the denominator includes the women, who are in the same age group and have their permanent residence in the same region at the given time interval. The required data for the numerator is acquired from central cervical screening registry, while the Statistical office of the Republic of Slovenia provides the data for the denominator. Screening attendance is one of the key preformance indicators, with which we can assess the effectiveness of the NP ZORA. The target for participation in screening is 70%. This means that at least 70% of all women should, in the given 3-year period, attend a screening visit for early detection of precancerous and cancerous lesions of the cervix performed by personal gynaecologists.

The results are shown by 5-year age groups and by territorial regions (Healthcare regions, Statistical regions, Administrative units and Municipalities). Detailed data is accessible in Excel spreadsheets, which can be downloaded by clicking the link at the bottom of the page. The results are shown for overlapping 3-year periods: 1 July 2007–30 June 2010; 1 July 2008–30 June 2011; 1 July 2009–30 June 2012; 1 July 2010–30. June 2013; 1 July 2011–30 June 2014; 1 July 2012–30 June 2015; 1 July 2013–30 June 2016; 1 July 2014–30 June 2017; 1 July 2015–30 June 2018; 1 July 2016–30 June 2019; 1 July 2017–30 June 2020; 1 July 2018–30 June 2021; 1 July 2019–30 June 2022; 1 July 2020–30 June 2023; 1 July 2021–30 June 2024.

EXPLANATION: As a result of the COVID-19 pandemic, we have observed a decrease in examination coverage in the 2017–2020 3-year period. Examination coverage is caluclated on data up to 30 June of each year. In 2020, this was less than two months after all non-urgent health services were halted at the national level between 11 March and 8 May 2020. At that time, cancer screening was not carried out, therefore we observed an expected decrease of examination coverage, which was 69.6% nationwide. This means that, for the first time in 15 years, we recorded an examination coverage that is less than the target value of 70%. However, immediately after the resumption of screening, we noticed a higher volume of cervical smear results compared to previous years (by more than 20%). Thus, examination coverage on 30 September 2020 had already increased to 70.6%. Despite the pandemic, the trend of increasing examnation coverage continued and it was 71.8% in the next 3-year period (2018–2021), which was already comparable to the pre-pandemic era. The 2020-2023 period then saw the highest level of screening since the programme's inception (74.5%), which decreased to 72.5% in the following 2021-2024 period. The decrease is due to the accumulation of a higher number of screenings in the aftermath of the lifting of the COVID-19 pandemic measures. The 2020-2023 period (1 July 2020–30 June 2023) starts after all screening was suspended between 11 March and 9 May 2020 and gynaecological clinics worked with increased workloads to make up for the missed screening due to the suspension, but does not include the period when screening was suspended. The marked increase was therefore mainly due to the timing of screening and the time period used to calculate the screening rate (the reverse effect of the decrease in 2017–2020), so the decrease in screening in 2021–2024 (1 July 2021–30 June 2024), when there was no longer an impact from the COVID-19 pandemic cessation, was to be expected.

 

Slovenian national cervical cancer screening programme examination coverage by age groups

Summary of screening results by age groups

  • Examination coverage of the target population of the national cervical cancer screening programme ZORA was exceeded the target value of 70% in all 3-year periods, except in 2017–2020, when screening was systematically halted by the government becouse of the COVID-19 pandemic.
  • Examination coverage is highest among younger women, the highest in the 25-29 age group, at 80.7%, as it has decreased in the 20–24 group in recent periods.
  • Despite the trend of increasing examination coverage in older age groups, it is still too low for women aged 55–64.  

 

Slovenian national cervical cancer screening programme examination coverage by territorial regions

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Summary of screening results by territorial regions in the last 3-year period (1 July 2020–30 June 2023)

HEALTHCARE REGIONS (HR):
  • The examination coverage exceeds the target value (70%) in six out of nine HR's, with the highest coverage in Nova Gorica (82.3%) and Ravne (75.7%).
  • The lowest coverage is in Koper (68.1%), Kranj (69.8%) and Murska Sobota (69.9%).
STATISTICAL REGIONS (SR):
  • Examination coverage exceeds the target in eight out of twelve SR's. The highest rates are found in Goriška (81.4%), Koroška (75.7%), Zasavska (75.2%) and Savinjska (75.0%) SR.
  • It is too low Obalno-Kraška (68.1%), Gorenjska (69.8%) in Primorsko-Notranjska and Pomurska (69.9%) SR.
ADMINISTRATIVE UNITS (AU): 
  • Examination coverage exceeds the target value in 42 of 58 AU. The highest value is in Tolmin (84.9%), Kobarid (84.1%), Miren-Kostanjevica (83.6%), Brda (83.5%), Šempeter-Vrtojba (83.2%) and Renče-Vogrsko (83.0%).
  • It is too small in 16 AU's, the lowest is in UE Piran (64.0%).
MUNICIPALITIES:
  • Examination coverage exceeds the target value in 160 out of 212 municipalities. It is the largest in municipalities of Tolmin (88.0%), Šmartno pri Litija (85.6%), Kobarid (85.3%), Cerkno (84.7%), Šempeter-Vrtojba (84.4%) and Brda (84.0%).
  • It is too small in 52 municipalities. The lowest coverage is in the municipalities of Oslilnica (47.5%), Kostel (57.3%) and Hodoš (57.4%).

 

Data download

You can transfer examination coverage data by territorial regions in Excel format by clicing the links below (tables are in Slovene):

 Slovenia

 Health regions

 Statistical regions

 Administrative units

 Municipalities

Examination coverage data by 5-year age groups is accessible on the link below (table is in Slovene):

 Examination coverage by 5-year age groups

 

Jerman T, Ivanuš U, Florjančič M. ZORA Programme Monitoring and Evaluation. ZORA: Slovenian National Cervical Cancer Screening Programme and Registry. 2025. https://zora.onko-i.si/en/monitoring-and-evaluation/.

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