{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:31:33Z","timestamp":1791667893588,"version":"4.3.4"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010676","name":"H2020 Societal Challenges","doi-asserted-by":"publisher","award":["847845"],"award-info":[{"award-number":["847845"]}],"id":[{"id":"10.13039\/100010676","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2025,1,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In well\u2010screened populations, most cervical cancers arise from small groups of women with inadequate screening. The present study aims to assess whether registry\u2010based cancer risk assessment could be used to increase screening intensity among high\u2010risk women. The National Cervical Screening Registry identified the 28,689 women residents in Sweden who had either no previous cervical screening or a screening history indicating high risk. We invited these women by SMS and\/or physical letter to order a free human papillomavirus (HPV) self\u2010sampling kit. The Swedish national HPV reference laboratory performed extended HPV genotyping and referred high\u2010risk HPV\u2010positive women to their regional gynecologist. A total of 3691\/28,689 (12.9%) women ordered a self\u2010sampling kit and 10.0% (2853\/28,689) returned a sample for testing. Participation among women who had never attended screening was low, albeit improved. Up to 22.5% of women in other high\u2010risk groups attended. High\u2010risk HPV types were detected in 8.3% of samples. High\u2010risk HPV\u2010positive women (238\/2853) were referred without further triaging and severe cervical precancer or cancer (HSIL+) in histopathology were detected in 36\/158 (23%) of biopsied women. Repeat invitations gave modest additional participation. Nationwide contacting of women with high risk for cervical cancer with personal invitations to order HPV self\u2010sampling kits resulted in high yield of detected CIN2+. Further efforts to improve risk\u2010stratified screening strategies should be directed to improving (i) the precision of the risk\u2010stratification algorithm, (ii) the convenience for the women to participate and, (iii) ensuring that screen\u2010positive women are followed\u2010up.<\/jats:p>","DOI":"10.1002\/ijc.35142","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T19:04:54Z","timestamp":1723748694000},"page":"379-388","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Nationwide registry\u2010based trial of risk\u2010stratified cervical screening"],"prefix":"10.1002","volume":"156","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2498-5206","authenticated-orcid":false,"given":"Laila Sara","family":"Arroyo M\u00fchr","sequence":"first","affiliation":[{"name":"Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology (CLINTEC) Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0001-503X","authenticated-orcid":false,"given":"Jiangrong","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology (CLINTEC) Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadaf S.","family":"Hassan","sequence":"additional","affiliation":[{"name":"Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology (CLINTEC) Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emel","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology (CLINTEC) Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0514-7226","authenticated-orcid":false,"given":"Miriam K.","family":"Elfstr\u00f6m","sequence":"additional","affiliation":[{"name":"Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology (CLINTEC) Karolinska Institutet  Stockholm Sweden"},{"name":"Center for Cervical Cancer Elimination Karolinska University Hospital Huddinge  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8588-6506","authenticated-orcid":false,"given":"Joakim","family":"Dillner","sequence":"additional","affiliation":[{"name":"Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology (CLINTEC) Karolinska Institutet  Stockholm Sweden"},{"name":"Center for Cervical Cancer Elimination Karolinska University Hospital Huddinge  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,15]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"World Health Organization.Cervical cancer elimination initiative (accessed 04 August 2023).https:\/\/www.who.int\/initiatives\/cervical-cancer-elimination-initiative."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969141316632023"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002414"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i276"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32416"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33769"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2015.12.007"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.12688\/openreseurope.13398.2"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-018-0053-6"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32374"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/rssa.12101"},{"key":"e_1_2_11_13_1","volume-title":"IARC Handbooks of Cancer 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