Women in Sweden are called every fifth or seventh year to do tests to detect cervical cancer. In 2024, over three million women between 23 and 70 years old were included in the screening program that has existed since the 60s.
For a long time, only cell sampling that looks for cell changes has been offered, also called cytology. But over the years, researchers have discovered that it is the human papillomavirus (HPV) that can lead to cell changes. Therefore, cell tests that look for HPV have also been introduced.
It's a much more sensitive way to look for risk factors for cervical cancer, because then you're looking for the cause, says Miriam Elfström, chairman of the national working group for prevention of cervical cancer and the care program group.
Tested "as soon as possible"
Since June, new recommendations therefore apply. Those who have been tested with cytology are no longer considered screened and should "as soon as possible" be offered an HPV test.
New cases (cancer) among people who have only been screened with cytology, they have increased over time in recent years, and then we really want to emphasize that one should only use HPV-based screening.
The change comes from updated recommendations in the national care program for cervical cancer prevention, which is in line with what now applies to the entire EU, which Dagens Medicin was the first to report.
Since 2015, HPV testing has been recommended for women over 30 years old and since 2022 for those under 30 years old.
Half a million not tested
How many are affected by the change is difficult to assess as they are lumped together with women who have not been called for various reasons. In 2024, the figure was over 76,000 women. The number of women who have not taken an HPV test is many more, in 2024 it was just over 500,000 women.
If you are unsure which test was done, you can look at the test result and see if it responds to whether the test included HPV or not, according to Miriam Elfström.
Everyone who has not taken an HPV test will be offered one as soon as possible. It is urgent that everyone keeps an eye out and participates when the offer comes and understands that it is a new, safer test that replaces the older test that was done before.
It is not possible to book a time for sampling yourself, it happens with a call.
Like everything else, if you are worried and have symptoms that may indicate some discomfort, you should always seek care, then you can always test yourself.
Human papillomavirus is abbreviated HPV and the route of infection is mainly through sexual contact. There are several different types of HPV, but it is twelve types that can cause cervical cancer. They are HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59. HPV 68 can probably cause cervical cancer. Three types entail a high risk of cancer. HPV 16 accounts for approximately 58 percent of cases, HPV 18 for approximately 17 percent and HPV 45 for approximately 6 percent. Nearly 90 percent of all HPV infections are transient and heal on their own within two years.
HPV vaccine is offered in Sweden and all children are offered it within the vaccination program. Three different HPV vaccines are approved for use in Europe and the USA. All protect against HPV 16 and 18. In Sweden, only Gardasil 9 is currently available. It also protects against HPV 6 and 11, which cause genital warts, as well as HPV 31, 33, 45, 52 and 58, which can lead to cancer. The seven types that can lead to cancer account for 90 percent of cervical cancer cases.
Women between 23 and 49 years old are recommended to have screening with HPV analysis every fifth year, while those over 50 years old are recommended to do so every seventh year. According to the new recommendations, women between 23 and 70 years old should be tested when they are vaccinated against HPV. When a self-sampling kit has been sent, a reminder should now be sent out eight weeks later. If an HPV result is positive but there are no cell changes, the woman should still be sent to a gynecologist.
Source: National care program for cervical cancer prevention, 1177
