Tens of thousands of women in Sweden will need new tests for cervical cancer after health authorities admitted that previous screenings were not reliable. The old method, based on cell changes alone, risks missing cancer cases.
Since the 1960s, Swedish women aged 23 to 70 have been invited to routine checks every five to seven years. For decades, these checks used cytology (the Pap smear) to look for abnormal cells. But research has shown that the real culprit is human papillomavirus (HPV). If HPV isn’t detected, cell changes may be overlooked until it’s too late.
“HPV testing is far more sensitive, because it looks for the cause of cervical cancer rather than just the effect,” said Miriam Elfström, chair of the national working group for cervical cancer prevention.
New national guidelines that came into force in June declare that women tested only with cytology are no longer considered properly screened. They will now be offered an HPV test “as soon as possible.”
Recent data has shown rising cancer cases among women who only had cytology, which led to the policy shift. The new rules align Sweden with EU standards.
HPV testing has been recommended for women over 30 since 2015 and extended to younger women in 2022. But the rollout has been uneven. In 2024 alone, more than 76,000 women were left out of the screening program, and more than 500,000 had yet to take an HPV test.
If you’re unsure which test you’ve had, look at the result: only HPV tests will say whether the virus was detected. Those who have not been HPV tested will be contacted automatically—booking on your own isn’t possible. Elfström urges women to participate once the new test is offered.
What to know about HPV
HPV is a common virus transmitted mainly through sexual contact. Around a dozen types can cause cervical cancer, with HPV 16, 18, and 45 being the most dangerous. HPV 16 alone accounts for more than half of cases. Most infections, however, clear on their own within two years.
Vaccination is available and part of Sweden’s national program for children. The vaccine currently used, Gardasil 9, protects against the high-risk types most likely to cause cancer, as well as strains that cause genital warts.
Updated screening schedule
- Ages 23–49: HPV test every 5 years
- Ages 50–70: HPV test every 7 years
- Women testing HPV-positive, even without visible cell changes, will be referred to a gynecologist.
Bottom line: only HPV testing now counts as valid cervical cancer screening in Sweden. Women who previously had only cytology will be called for retesting.