Acta obstetricia et gynecologica Scandinavica · 2026
Real-world evaluation of a population-based vaginal self-sampling program for cervical cancer prevention in Region Skåne, Sweden.
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Hellsten Caroline, Forslund Ola, Borgfeldt Christer
Аннотация
INTRODUCTION: Cervical cancer represents a significant public health challenge worldwide. To improve screening accessibility and participation, we implemented vaginal human papilloma virus (HPV) self-sampling as part of an organized cervical cancer prevention strategy. This study aimed to evaluate the implementation and outcomes of the self-sampling program in a real-world setting.
MATERIAL AND METHODS: Between September 1, 2021 and December 31, 2024, a total of 557 976 vaginal self-sampling kits were distributed. Follow-up with cervical sampling continued through April 2025. Data were collected using the Laboratory Information Management System (LIMS) and the Melior Journal system.
RESULTS: Of the distributed kits, 208 386 were returned, yielding an adherence rate of 37% (208 386/557 976). Among the valid samples, 19% (39 697/204 763) tested positive for HPV. Follow-up adherence among HPV-positive women was 81% (32 305/39 697), defined as attendance at follow-up clinics by the end of the fourth subsequent calendar month. Cervical samples were HPV-positive in 39% (12 495/32 305) and HPV16 or HPV18/45 were detected in 2157 cases (17%). Cytological analysis identified high-grade cervical dysplasia in 759 women (6.1%, 759/12 505) and histopathology confirmed its presence in 980 cases (13%, 980/7641). Cervical cancer was diagnosed in 32 cervical biopsies (0.4%, 32/7647).
CONCLUSIONS: The vaginal self-sampling program was effective in detecting HPV. Its capacity to identify HPV types and significant cytological abnormalities underscores its potential for facilitating early detection, enhancing screening coverage and timely clinical intervention, thereby reducing the incidence of cervical cancer.
MATERIAL AND METHODS: Between September 1, 2021 and December 31, 2024, a total of 557 976 vaginal self-sampling kits were distributed. Follow-up with cervical sampling continued through April 2025. Data were collected using the Laboratory Information Management System (LIMS) and the Melior Journal system.
RESULTS: Of the distributed kits, 208 386 were returned, yielding an adherence rate of 37% (208 386/557 976). Among the valid samples, 19% (39 697/204 763) tested positive for HPV. Follow-up adherence among HPV-positive women was 81% (32 305/39 697), defined as attendance at follow-up clinics by the end of the fourth subsequent calendar month. Cervical samples were HPV-positive in 39% (12 495/32 305) and HPV16 or HPV18/45 were detected in 2157 cases (17%). Cytological analysis identified high-grade cervical dysplasia in 759 women (6.1%, 759/12 505) and histopathology confirmed its presence in 980 cases (13%, 980/7641). Cervical cancer was diagnosed in 32 cervical biopsies (0.4%, 32/7647).
CONCLUSIONS: The vaginal self-sampling program was effective in detecting HPV. Its capacity to identify HPV types and significant cytological abnormalities underscores its potential for facilitating early detection, enhancing screening coverage and timely clinical intervention, thereby reducing the incidence of cervical cancer.