ArticleEuropean journal of public health2024
Divergent effects of switching from cytology to HPV-based screening in the Nordic countries.
Article in European journal of public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Five-Year Risk of CIN3+ After CIN1 Biopsy in a Norwegian Screening Setting: Comparison of CIN1 Diagnosed in a Single Calendar Year and in Two Consecutive Calendar Years.Pathogens (Basel, Switzerland) · 2026Article
- The incidence of high-risk HPV infections in Slovakia at the start of the national organized screening for cervical cancer.Infectious agents and cancer · 2025Article
- Impact of HPV Catch-Up Vaccination on High-Grade Cervical Lesions (CIN2+) Among Women Aged 26-30 in Northern Norway.Vaccines · 2025Article
- High risk human papillomavirus versus cytological screening over two rounds in Finnish screening programme for cervical cancer: population based cohort study.BMJ medicine · 2025Article
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Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundCervical cytology has been the primary method of cervical cancer screening for decades. Tests that detect viral HPV are shown in several randomized trials to provide better protection against cancer compared with cytology. HPV-based screening has been implemented alongside cytology in the Nordic countries for several years. The aim of this study was to compare cytology and HPV-based screening in the colposcopy referrals and detection rates of cervical lesions.
methodsIndividual-level screening data from Finland, Iceland, Norway and Sweden were harmonized and aggregated locally. We utilized data for tests taken during years 2015-17 and biopsies taken during years 2015-19 to allow 24 months of follow-up. Age-standardized estimates and age-adjusted risk ratios for six different outcomes of screening management were calculated.
resultsThe age-standardized colposcopy rates were higher in HPV-based testing compared with cytology in Finland (3.5% vs. 0.9%) and Norway (6.0% vs. 4.1%) but lower in Sweden (3.7% vs. 4.9%). The relative detection rate of cervical intraepithelial neoplasia grade 2 and above in HPV-based testing compared with cytology was highest in Finland (RR 2.37, 95% CI 2.13-2.63) and Norway (RR 1.66, 95% CI 1.57-1.72) while in Sweden the difference was not statistically significant (RR 0.98, 95% CI 0.95-1.00).
conclusionsThe effects of implementing HPV screening varied by country as different screening algorithms were implemented. HPV-based screening increases colposcopy rates mainly through referrals from increased repeat testing and detection rate is therefore significantly higher compared with cytology. Monitoring of these indicators in subsequent rounds of HPV-based screening remains essential.
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