Center for Cervical Cancer Elimination, F46, Pathology and Cancer Diagnostics, Medical Diagnostics Karolinska, Karolinska University Hospital and Division of Cervical Cancer Elimination, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
Regional Cancer Center of Stockholm-Gotland, Cancer Screening Unit, Sweden, Stockholm, Sweden.
Elife. 2023 Dec 12;12:e80905. doi: 10.7554/eLife.80905.
At the onset of the COVID-19 pandemic cervical screening in the capital region of Sweden was canceled for several months. A series of measures to preserve and improve the cervical screening under the circumstances were instituted, including a switch to screening with HPV self-sampling to enable screening in compliance with social distancing recommendations.
We describe the major changes implemented, which were (1) nationwide implementation of HPV screening, (2) switch to primary self-sampling instead of clinician sampling, (3) implementation of HPV screening in all screening ages, and (4) combined HPV vaccination and HPV screening in the cervical screening program.
A temporary government regulation allowed primary self-sampling with HPV screening in all ages. In the Stockholm region, 330,000 self-sampling kits were sent to the home address of screening-eligible women, instead of an invitation to clinician sampling. An increase in organized population test coverage was seen (from 54% to 60% in just 1 year). In addition, a national campaign for faster elimination of cervical cancer with concomitant screening and vaccination for women in ages 23-28 was launched.
The COVID-19 pandemic necessitated major changes in the cervical cancer preventive strategies, where it can already be concluded that the strategy with organized primary self-sampling for HPV has resulted in a major improvement of population test coverage.
Funded by the Swedish Association of Local Authorities and Regions, the Swedish Cancer Society, the European Union's Horizon 2020 Research and Innovation Program, the Swedish government, and the Stockholm county.
在 COVID-19 大流行期间，瑞典首都地区的宫颈筛查被取消了数月。为了在这种情况下保留和改善宫颈筛查，采取了一系列措施，包括改用 HPV 自我采样筛查，以符合社交距离建议。
我们描述了实施的主要变化，包括（1）全国范围内实施 HPV 筛查，（2）改为主要自我采样而不是临床医生采样，（3）在所有筛查年龄实施 HPV 筛查，以及（4）在宫颈筛查计划中结合 HPV 疫苗接种和 HPV 筛查。
临时政府规定允许所有年龄段的主要自我采样 HPV 筛查。在斯德哥尔摩地区，向符合筛查条件的妇女的家庭住址发送了 33 万份自我采样试剂盒，而不是邀请临床医生采样。有组织的人群检测覆盖率有所增加（仅在 1 年内从 54%增加到 60%）。此外，启动了一项全国性运动，旨在通过同时进行筛查和接种疫苗，加快消除 23-28 岁女性的宫颈癌。
COVID-19 大流行需要对宫颈癌预防策略进行重大改变，已经可以得出结论，采用有组织的主要自我采样 HPV 策略已经大大提高了人群检测覆盖率。
由瑞典地方当局和地区协会、瑞典癌症协会、欧盟的地平线 2020 研究和创新计划、瑞典政府和斯德哥尔摩县资助。
