Design principles and core components of cervical screening registries in the HPV era: a narrative review and global framework

Achieving the World Health Organization's cervical cancer elimination targets requires high screening coverage and timely follow-up of abnormal results.These functions depend on robust cervical screening registries capable of tracking the full continuum from invitation to testing, triage, management and outcomes.Yet most countries lack such systems; existing registries typically capture cancer incidence rather than screening pathways.The transition to human papillomavirus (HPV) primary testing, the rapid expansion of self-sampling and the need to monitor every step of the elimination cascade make modern screening registries essential.However, no global guidance exists on how to design or implement them.This narrative review proposes a comprehensive framework for cervical screening registries suited to contemporary screening strategies.The framework outlines six core functions that will further enable evaluation of the screening programme, including: defining the eligible population, monitoring or issuing invitations and reminders, screening history including HPV and triage testing, tracking followup and management, linking to pathology and cancer registries, and supporting routine quality assurance.A minimal dataset is described, covering population records, eligibility, invitations, sample characteristics (including self-sampling), HPV results, triage investigations, follow-up procedures and outcomes including cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and interval cancers.The framework also details key implementation principles, including interoperability across health information systems, digital architecture options, data quality assurance, governance and privacy considerations, and equity-focused strategies for underserved or displaced populations.The framework is adaptable across diverse health-system contexts.Establishing or strengthening cervical screening registries will be essential to support modern HPV-based screening and accelerate progress toward cervical cancer elimination.