Sweden has had organized screening programs against cervical cancer, with regular gynecological cell test checks, since the 1960s. This has contributed to a sharp reduction in cancer cases, but in the last five years, the number of people with illness has increased dramatically - by about 100 cases - to about 550 cases annually.
And the increase continues. It shows fresh figures from 2018, which are presented in a report from the National Quality Register for Cervical Cancer Prevention.
- The main reason for the increase is that we have seen an increased risk of cancer despite having a normal cell sample. We see this in particular in regions that do not follow the National Board of Health's latest guidelines on primary HPV analysis in cell tests but still work in the old way, says Joakim Dillner, professor of infectious diseases and chairman of the quality register.
"Inequal care not acceptable"Since 2015, the National Board of Health recommends that women who are 30 years and older should be tested primarily for human papillomavirus, HPV, in their gynecological cell test. This is because it is a more sensitive test, which can find a new group of women, those with residual HPV without cell changes.
However, a survey conducted by SVT News shows that only 13 of the country's 21 regions follow the recommendations.
- If I was a woman over 30 and living in one of the regions that did not introduce primary HPV analysis, I would ask the politicians why it is this way. It is not acceptable to have less protection than those in other parts of the country, says Joakim Dillner.
In many regions, cervical cancer is now as common as before screening was introduced over 50 years ago, according to the new report. Joakim Dillner believes that the negative trend can only be reversed through national coordination.
- It was so slow when it was time for change, which led to unequal care. Even if the regions take power over the whole process, national coordination provides an opportunity for improvement work where everyone is involved at the same time.
The National Board of Health and Welfare investigates the screeningThe National Board of Health has been commissioned by the government to evaluate the screening program for cervical cancer. The investigation should be completed in June 2020, but Joakim Dillner thinks it is going too slowly.
- I feel a little worried. For every year that passes, women needlessly get cervical cancer. This is the third year in a row that we are pointing out that this is a huge problem, but these are rather limited measures.