{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T20:54:41Z","timestamp":1788814481487,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Regular audits are essential for monitoring and evaluation of cervical screening. We audited the Swedish cervical screening program during the transition to HPV\u2010based screening using a registry\u2010based cohort design. In total, 5689 consecutive, confirmed cases of invasive cervical cancer between 2012 and 2022 were retrieved from the Swedish Quality Register for Gynecological Cancer. Their screening history, screening status, invitations to cervical screening, all diagnoses in screening cytology and HPV genotypes were retrieved from the Swedish National Cervical Screening Registry. Furthermore, all cancer cases during 2018\u20132022 were classified according to their screening history and the age\u2010standardized cervical cancer incidence rate stratified by screening history and calendar year was calculated among the cohort of all women in Sweden ages 29\u201384. Non\u2010participation remains the main process related history with high risk of cancer (cervical cancer incidence rate, IR, among non\u2010attenders was 33.9 [95% confidence intervals, 95% CI, 28.2\u201339.5] per 100,000 person\u2010years, \/100,000PY, representing 31% of cases in 2022). The cervical cancer IR after negative cytology increased with calendar time (IR\u2009=\u20095.5 [95% CI, 4.1\u20136.8]\/100,000PY in 2012 and 11.5 [8.1\u201314.9]\/100,000PY in 2022) and was high after a positive HPV test followed by negative cytology triage (IR\u2009=\u200956.7 [39.9\u201373.6] in 2022). In conclusion, this comprehensive audit has identified a decreasing protection by the screening test under discontinuation (cytology) and that the performance as a triage test after HPV\u2010testing is unsatisfactory.<\/jats:p>","DOI":"10.1002\/ijc.70415","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T03:24:23Z","timestamp":1773113063000},"page":"467-477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nationwide audit of cervical cancer screening reveals unsatisfactory triage strategies and trends over time in incidence among cytology negative women"],"prefix":"10.1002","volume":"159","author":[{"given":"Cecilia","family":"K\u00e4rrberg","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Obstetrics and Gynecology Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9065-4734","authenticated-orcid":false,"given":"Penelope","family":"Gray","sequence":"additional","affiliation":[{"name":"Center for Cervical Cancer Elimination, Department of Clinical Science Intervention and Technology, Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Elfgren","sequence":"additional","affiliation":[{"name":"Regional Cancer Center  Stockholm Gotland Sweden"},{"name":"Division of Obstetrics and Gynaecology, Department of Clinical Science Intervention and Technology, Karolinska Institutet  Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Milerad","sequence":"additional","affiliation":[{"name":"Regional Cancer Center  Stockholm Gotland Sweden"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengt","family":"Andrae","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4718-1414","authenticated-orcid":false,"given":"Jiayao","family":"Lei","sequence":"additional","affiliation":[{"name":"Center for Cervical Cancer Elimination, Department of Clinical Science Intervention and Technology, Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4r","family":"Spar\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  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, Karolinska Institutet  Stockholm Sweden"},{"name":"Center for Cervical Cancer Elimination, Molecular Cancer Diagnostics &amp; Screening Karolinska University Hospital  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, Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0514-7226","authenticated-orcid":false,"given":"K. Miriam","family":"Elfstr\u00f6m","sequence":"additional","affiliation":[{"name":"Center for Cervical Cancer Elimination, Department of Clinical Science Intervention and Technology, Karolinska Institutet  Stockholm Sweden"},{"name":"Center for Cervical Cancer Elimination, Molecular Cancer Diagnostics &amp; Screening Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"4","key":"e_1_2_12_2_1","first-page":"S1","article-title":"European guidelines for quality Assurance in Cervical Cancer Screening. 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