{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:09:48Z","timestamp":1777928988040,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Nordic Cancer Union"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Med Screen"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare primary test positivity in cytology and human papillomavirus-based screening between different Nordic cervical cancer screening programs using harmonized register data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study utilized individual-level data available in national databases in Finland, Iceland, Norway, and Sweden. Cervical test data from each country were converted to standard format and aggregated by calculating the number of test episodes for every test result for each calendar year and one-year age group and test method. Test positivity was estimated as the proportion of positive test results of all primary test episodes with a valid test result for \u201cany positive\u201d and \u201cclearly positive\u201d results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The age-adjusted rate ratio for any positive test results in primary human papillomavirus-based screening compared to cytology was 1.66 (95% CI 1.64\u20131.68). The age-adjusted rate ratio for clearly positive test results was 1.02 (95% CI 1.00\u20131.05). A decreasing rate ratio by age was seen in both any positive and clearly positive test results. Test positivity increased over time in Iceland, Norway, and Sweden but slightly decreased in Finland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The probability of any positive test result was higher in human papillomavirus testing than in primary cytology, even though the cross-sectional detection of a clearly positive test result was the same. Human papillomavirus testing can still lead to an improved longitudinal sensitivity through a larger number of follow-up tests and the opportunity to identify women with a persistent human papillomavirus infection. Further research on histologically verified precancerous lesions is needed in primary as well as repeat testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0969141321992404","type":"journal-article","created":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T06:02:02Z","timestamp":1613196122000},"page":"464-471","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of cytology and human papillomavirus-based primary testing in cervical screening programs in the Nordic countries"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4623-3673","authenticated-orcid":false,"given":"Veli-Matti","family":"Partanen","sequence":"first","affiliation":[{"name":"Finnish Cancer Registry, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joakim","family":"Dillner","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameli","family":"Trop\u00e9","sequence":"additional","affiliation":[{"name":"Section for Cervical Cancer Screening, Cancer Registry of Norway, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1g\u00fast Ingi","family":"\u00c1g\u00fastsson","sequence":"additional","affiliation":[{"name":"Cancer Detection Clinic, The Icelandic Cancer Society, Reykjavik, Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maiju","family":"Pankakoski","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sirpa","family":"Hein\u00e4vaara","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tytti","family":"Sarkeala","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiangrong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gry Baadstrand","family":"Skare","sequence":"additional","affiliation":[{"name":"Section for Cervical Cancer Screening, Cancer Registry of Norway, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahti","family":"Anttila","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"L\u00f6nnberg","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"bibr1-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(19990924)83:1<59::AID-IJC12>3.0.CO;2-N"},{"key":"bibr2-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1080\/00016340500324423"},{"key":"bibr3-0969141321992404","unstructured":"Engholm G, Ferlay J, Christensen N, et\u00a0al. Cancer incidence, mortality, prevalence and survival in the Nordic countries, version 8.1 (28.06.2018). Association of the Nordic Cancer Registries, Danish Cancer Society, Copenhagen, Denmark, 2018."},{"key":"bibr4-0969141321992404","first-page":"1","volume":"115","author":"Dillner J","year":"2018","journal-title":"Lakartidningen"},{"key":"bibr5-0969141321992404","author":"Anttila A","year":"2020","journal-title":"Finnish Cancer Registry"},{"key":"bibr6-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-015867"},{"key":"bibr7-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.06.095"},{"key":"bibr8-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0185332"},{"key":"bibr9-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.05.089"},{"key":"bibr10-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31261"},{"key":"bibr11-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1804"},{"key":"bibr12-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2019.1615637"},{"key":"bibr13-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2020.1821089"},{"key":"bibr14-0969141321992404","unstructured":"Nationellt Kvalitetsregister f\u00f6r Cervixcancerprevention (NKCx). \nF\u00f6rebyggande av livmoderhalscancer i Sverige\u2014Verksamhetsber\u00e4ttelse och \u00e5rsrapport 2019 med data till och med 2018. 2019. [Prevention of Cervical Cancer in Sweden\u2014Annual Report 2019 with Data up to 2018] 2019; 1\u2013104."},{"key":"bibr15-0969141321992404","author":"Cancer Registry of Norway.","year":"2018","journal-title":"[Cervical Program\u2014Annual Report 2016]"},{"key":"bibr16-0969141321992404","volume-title":"European Guidelines for Quality Assurance in Cervical Cancer Screening","author":"Arbyn EM","year":"2008","edition":"2"},{"key":"bibr17-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13313"},{"key":"bibr18-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13013"},{"key":"bibr19-0969141321992404","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50223"},{"key":"bibr20-0969141321992404","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S243546"},{"key":"bibr21-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-020-0790-1"},{"key":"bibr22-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29143"},{"key":"bibr23-0969141321992404","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33128"}],"container-title":["Journal of Medical Screening"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0969141321992404","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0969141321992404","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0969141321992404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:25:18Z","timestamp":1777677918000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0969141321992404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,9]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1177\/0969141321992404"],"URL":"https:\/\/doi.org\/10.1177\/0969141321992404","relation":{},"ISSN":["0969-1413","1475-5793"],"issn-type":[{"value":"0969-1413","type":"print"},{"value":"1475-5793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,9]]}}}