{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:04:05Z","timestamp":1784887445902,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"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":[[2026,9,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    On mandate from the Danish Health Authority, a nationwide health care policy trial (HCP) of primary HPV screening for women aged 30\u201359 was initiated in 2021. The aim was to inform on the performance of HPV screening in comparison to existing cytology practice. The HCP trial included all Danish women between 30 and 59\u2009years of age undergoing cervical cancer screening in 2021 (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009178,323). Women with odd birthdays were screened with HPV screening (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200991,517), while women born on even dates were screened with cytology (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200986,806). The follow\u2010up period was individually censored at 18\u2009months from the screening date. Outcomes and intention\u2010to\u2010treat analysis are reported. Overall, 9.1% and 3.0% were HPV or cytology positive on the index sample. Referral to colposcopy upon index sample was 1.9% with HPV and 2.1% with cytology screening. Referral to retest after a positive HPV index sample result was 7.7 higher for HPV than cytology. Combining index and retest rounds, 6.3% women had colposcopy in the HPV arm (RR 1.28) versus 4,9% in the cytology arm. HPV screening detected both more disease \u2265\u2009CIN2 (RR 1.51) and \u2265\u2009CIN3 (RR1.35). The national\u2010scale health care policy implementation trial showed that HPV\u2010based cervical cancer screening increased detection of histologically defined disease compared to the previous policy of cytology\u2010based screening for women 30\u201359\u2009years of age. The HCP demonstrated the real\u2010life effect of HPV\u2010based screening over cytology\u2010based screening in detection of disease, but also details what to be expected in terms of health care resource requirements.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70502","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:01:08Z","timestamp":1777348868000},"page":"1464-1476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health Care Policy Implementation Trial of Primary Human Papillomavirus\u2013Based Cervical Screening in Denmark"],"prefix":"10.1002","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4853-6747","authenticated-orcid":false,"given":"Jesper","family":"Bonde","sequence":"first","affiliation":[{"name":"Molecular Pathology Laboratory, Pathology, Afs. 134, AHH\u2010Hvidovre Hospital, Copenhagen University Hospital  Hvidovre Capital Region of Denmark Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeppe Bennekou","family":"Schroll","sequence":"additional","affiliation":[{"name":"Department of Clinical, Research Cochrane Denmark &amp; Centre for Evidence\u2010Based Medicine Odense (CEBMO) University of Southern Denmark  Odense Denmark"},{"name":"Open Patient Data Explorative Network (OPEN), Odense University Hospital  Odense Denmark"},{"name":"Department of Gynecology &amp; Obstetrics Herlev\u2010Gentofte Hospital  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte T\u00f8nnes","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Molecular Pathology Laboratory, Pathology, Afs. 134, AHH\u2010Hvidovre Hospital, Copenhagen University Hospital  Hvidovre Capital Region of Denmark Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-5236","authenticated-orcid":false,"given":"Elsebeth","family":"Lynge","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Waldstr\u00f8m","sequence":"additional","affiliation":[{"name":"Department of Pathology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra Hall","family":"Viborg","sequence":"additional","affiliation":[{"name":"The Danish Healthcare Quality Institute  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Frandsen","sequence":"additional","affiliation":[{"name":"Department of Pathology Aalborg University Hospital  \u00c5lborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke Holst","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Pathology Region Hospital Randers  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Region Zealand  N\u00e6stved Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Schledermann","sequence":"additional","affiliation":[{"name":"Department of Pathology Lille Baelt Hospital  Vejle Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina Kj\u00e6r","family":"Kristensen","sequence":"additional","affiliation":[{"name":"UNICCA\u2014University Research Clinic for Cancer Screening, Department of Public Health Programs, Randers Regional Hospital  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Andersen","sequence":"additional","affiliation":[{"name":"UNICCA\u2014University Research Clinic for Cancer Screening, Department of Public Health Programs, Randers Regional Hospital  Randers Denmark"},{"name":"Department of Clinical Medicine, Health Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the National Danish Cervical Cancer Screening Steering Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/apm.12279"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00487-3"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30729-4"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l5668"},{"key":"e_1_2_14_6_1","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem","author":"Organization WH","year":"2020"},{"key":"e_1_2_14_7_1","unstructured":"Organisation UNWH \u201cGoal 3: Good Health Cervical Cancer \u201d(2016)."},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31261"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pvr.2015.06.006"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31043"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60645-0"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o1303"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-22-0340"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2015.09.014"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.24010"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.04.031"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.29881"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17058"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l240"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003748"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-2735"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737159.2019.1613890"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016700"},{"issue":"8","key":"e_1_2_14_25_1","article-title":"Cytology Versus HPV Testing for Cervical Cancer Screening in the General Population","volume":"8","author":"Koliopoulos G.","year":"2017","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_14_26_1","unstructured":"Sundhedsstyrelsen \u201cScreening for Livmoderhalskr\u00e6ft\u2014Anbefalinger \u201d(2018) https:\/\/wwwsstdk\/da\/Udgivelser\/\/Screening\u2010for\u2010livmoderhalskraeft."},{"issue":"9","key":"e_1_2_14_27_1","article-title":"Phased Implementation of HPV\u2010Based Cervical Cancer Screening in Denmark","volume":"184","author":"Bonde J.","year":"2022","journal-title":"Ugeskrift for Laeger"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2019.04.680"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004522"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14915"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S243546"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104336"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqab138"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00508-16"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01518-19"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17248"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29290"},{"key":"e_1_2_14_38_1","unstructured":"Kvalitetsudviklingsprogram RK \u201cDansk Kvalitetsdatabase for Livmoderhalskr\u00e6ftscreening RKK \u201d(2022) Dansk Kvalitetsdatabase for Livmoderhalskr\u00e6ftscreening 2021."},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41597-024-03519-2"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.70365"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2017.05.020"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.35359"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.35142"},{"key":"e_1_2_14_44_1","unstructured":"Registry SNCS \u201cSwedish National Cervical Cancer Screening Registry \u201d(2022)."},{"key":"e_1_2_14_45_1","article-title":"Long Term Duration of Protective Effect for HPV Negative Women: Follow\u2010Up of Primary HPV Screening Randomised Controlled Trial","volume":"348","author":"Elfstrom K. M.","year":"2014","journal-title":"BMJ (Clinical Research Ed.)"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-068776"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.70502","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijc.70502","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.70502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T09:23:53Z","timestamp":1784885033000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.70502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":45,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,9,15]]}},"alternative-id":["10.1002\/ijc.70502"],"URL":"https:\/\/doi.org\/10.1002\/ijc.70502","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,27]]},"assertion":[{"value":"2025-04-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}