Evidence map›Paper›PMID 41803020›Full record

ArticleInternational journal of cancer2026

Nationwide audit of cervical cancer screening reveals unsatisfactory triage strategies and trends over time in incidence among cytology negative women.

Cecilia Kärrberg, Penelope Gray, Kristina Elfgren, Hanna Milerad, Bengt Andrae, Jiayao Lei, Pär Sparén, Joakim Dillner, Jiangrong Wang, K Miriam Elfström

Abstract read
In one paragraph

Article in International journal of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Cecilia KärrbergDepartment of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Penelope GrayCenter for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-9065-4734
Kristina ElfgrenRegional Cancer Center, Stockholm, Gotland, Sweden.
Hanna MileradRegional Cancer Center, Stockholm, Gotland, Sweden.
Bengt AndraeDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Jiayao LeiCenter for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-4718-1414
Pär SparénDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Joakim DillnerCenter for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-8588-6506
Jiangrong WangCenter for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-0001-503X
K Miriam ElfströmCenter for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-0514-7226

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Regular audits are essential for monitoring and evaluation of cervical screening. We audited the Swedish cervical screening program during the transition to HPV-based screening using a registry-based cohort design. In total, 5689 consecutive, confirmed cases of invasive cervical cancer between 2012 and 2022 were retrieved from the Swedish Quality Register for Gynecological Cancer. Their screening history, screening status, invitations to cervical screening, all diagnoses in screening cytology and HPV genotypes were retrieved from the Swedish National Cervical Screening Registry. Furthermore, all cancer cases during 2018-2022 were classified according to their screening history and the age-standardized cervical cancer incidence rate stratified by screening history and calendar year was calculated among the cohort of all women in Sweden ages 29-84. Non-participation remains the main process related history with high risk of cancer (cervical cancer incidence rate, IR, among non-attenders was 33.9 [95% confidence intervals, 95% CI, 28.2-39.5] per 100,000 person-years, /100,000PY, representing 31% of cases in 2022). The cervical cancer IR after negative cytology increased with calendar time (IR = 5.5 [95% CI, 4.1-6.8]/100,000PY in 2012 and 11.5 [8.1-14.9]/100,000PY in 2022) and was high after a positive HPV test followed by negative cytology triage (IR = 56.7 [39.9-73.6] in 2022). In conclusion, this comprehensive audit has identified a decreasing protection by the screening test under discontinuation (cytology) and that the performance as a triage test after HPV-testing is unsatisfactory.

Indexed as

Early Detection of CancerPapillomavirus InfectionsTriageUterine Cervical NeoplasmsAdultAgedAged, 80 and overFemaleHuman Papillomavirus VirusesHumansIncidenceMass ScreeningMiddle AgedRegistriesSwedencervical cancerHPV‐based screeningquality assurancescreening audit

Identifiers

PMID41803020
PMCPMC13193424

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.