Technological advances: Have they improved standards? Review of outcomes from the Welsh cervical screening programme.

Introduction of new technologies into cervical screening programmes has allowed more efficient programmes with less resources. We present an overview of screening technologies introduced into the Cervical Screening Wales programme and their evolution over time. Data from the programme's statistical report were used to evaluate its performance over a 17-year period between 2001/02 and 2017/18. The introduction of liquid-based cytology has had a substantial impact on reducing inadequate sample rates and on increasing the positive predictive value of cytology. Inadequate rates have increased following the implementation of human papilloma virus testing as a triage test for cytology. Further knock-on effects on standard reporting ranges are expected following the introduction of human papilloma virus testing as the primary screening test. New performance standards have been introduced to better reflect the performance of the programme at a time when disease prevalence is expected to fall as women vaccinated against human papilloma virus reach screening age. Improvements to this cervical cancer screening programme as illustrated through performance indicator ranges suggest a major role played by technology.