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Chromogenic In Situ Hybridization as a Tool for HPV-Related Head and Neck Cancer Diagnosis
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Quality indicators for cervical screening in Sweden.

Helena Andersson1,2, Sara Nordqvist Kleppe1,2, Henrik Edvardsson3

  • 1Center for Cervical Cancer Elimination, Pathology and Cancer Diagnostics, Medical Diagnostics Karolinska, Karolinska University Hospital, Stockholm, Sweden.

Journal of Medical Screening
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PubMed
Summary

Swedish cervical screening uses 13 quality indicators (QI) to monitor performance. HPV self-sampling maintained high coverage during the pandemic, but follow-up for CIN2+ needs improvement.

Keywords:
HPVQuality indicatorscancer preventioncervical cancerhuman papillomavirusscreening

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Area of Science:

  • Public Health
  • Gynecologic Oncology
  • Epidemiology

Background:

  • Quality indicators (QI) are crucial for screening program evaluation but often lack standardization and publication.
  • Cervical screening programs rely on QIs for comparisons and optimization, necessitating clear reporting standards.

Purpose of the Study:

  • To report 13 established quality indicators (QIs) for cervical screening in Sweden.
  • To analyze trends, observations, and the impact of the COVID-19 pandemic on cervical screening QIs.

Main Methods:

  • Data collection from the Swedish National Cervical Screening Registry, including invitations, HPV/cytology/histopathology results, population data, and cancer statistics.
  • Calculation and analysis of 13 specific QIs for cervical screening.

Main Results:

  • High population coverage (83%) for HPV screening, with widespread adoption of self-sampling.
  • Follow-up for CIN2+ improved from 60% within 3 months to over 95% within 1 year.
  • Decreased incidence and mortality of cervical cancer; some QIs became outdated, and regional variability was noted.

Conclusions:

  • HPV self-sampling ensured consistent screening coverage during the pandemic despite appointment cancellations.
  • Improving follow-up for screen-positive cases and increasing HPV self-sampling uptake are key areas for enhancement.