Population-based cervical screening with Human Papillomavirus self-sampling at home and incidence of cervical cancer in Sweden
To describe the Swedish 2020 switch to primary cervical screening using Human Papillomavirus (HPV) self-sampling at home and compare with cervical cancer incidence trends. Statistics on HPV self-sampling and cervical cancer incidence up to 2024-12-31 were obtained from comprehensive nationwide registries. HPV self-sampling was recommended in 2017 for non-attending women and was in 2020 recommended as a primary screening for all women aged 23-70 years of age. During 2016-2020 there were < 20,000 annual self-samples taken, but since 2021 > 200,000 self-samples are taken annually (about half of all screening tests). During 2015 to 2020 the cervical cancer incidence was stable, between 11 and 12 per 100,000 women. From 2021 and onwards the incidence is declining and was 7,7/100,000 in 2024. The decline is stronger among women younger than 30 (-60%) but is strong in all ages (-27%). A rapid introduction of primary HPV self-sampling at home in 2020-2021 was followed by a rapid decline in invasive cervical cancer incidence.