We evaluated the effectiveness of primary HPV screening for women aged 30-64 when introduced into an organised, population-based cervical screening program in Sweden.
HPV based primary screening was implemented in the organized screening program in the greater Stockholm county in June 2014, randomising 50% of all resident women 30-60 years to either primary HPV screening with cytology triage or to primary cytology, in 2015 the age was extended to 30-64 years. HPV+/Cyt- women in the screening ages are referred to the next round of organised screening, whereas HPV+/Cyt- women aged 64 (who otherwise would have been acquitted from the programme) will continue to be screened. The primary evaluation is the sensitivity for CIN2+ detection and cost-effectiveness of the new policy in relation to the previously used policy
68674 primary HPV test were performed starting in June 2014 to December 2015. The population HPV prevalence was 8,3 % and there was a 91,7 % decline in number of cytologies performed. During 2014, 26539 women attended any of the two arms of the screening program. 0,25 and 0,27 % of the women were diagnosed with CIN2+. No women with persisting HPV have yet been referred to colposcopy therefore a similar number of CIN2+ in both arms are the expected results.
Primary HPV screening is acceptable to the population, results in higher attendance rates and reduces the screening costs.