Cervical cancer screening in the European context – from cytology to primary HPV testing

Czech version

Authors: Nikola Janovská ; Lukáš Rob ; T. Pichlík; Borek Sehnal ; K. Robová ; Michael Jiří Halaška ; Helena Robová
Authors‘ workplace: Gynekologicko-porodnická klinika 3. LF UK a FNKV, Praha
Published in: Ceska Gynekol 2026; 91(1): 69-76
Category:
doi: https://doi.org/10.48095/cccg202669

Overview

Cervical cancer remains a major global health challenge, despite the availability of effective preventive measures such as human papillomavirus (HPV) vaccination, early detection and treatment of precancerous lesions, and timely management of early-stage disease. In recent years, several European countries have introduced substantial changes to their screening strategies –shifting from conventional cytology to primary HPV testing. This shift, supported by the World Health Organization and International Agency for Research on Cancer recommendations, is underpinned by numerous clinical studies demonstrating the superior sensitivity of HPV testing for detecting high-grade cervical lesions. This article provides an up-to-date overview of cervical cancer screening across Europe, with a focus on screening methods, testing intervals, program organization, and the emerging role of self-sampling.

Keywords:

prevention – cervical cancer – screening – human papillomavirus – oncologic cytology

Sources

1. Dušek L, University M. Epidemiologie zhoubných nádorů v České republice. Masaryk University 2012. 2025 [online]. Available from: https: //portal.med.muni.cz/clanek-583-epidemiologie-zhoubnych-nadoru-v-ceske-republice.html.

2. Wu J, Jin Q, Zhang Y et al. Global burden of cervical cancer: current estimates, temporal trend and future projections based on the GLOBOCAN 2022. J Natl Cancer Cent 2025; 5 (3): 322–329. doi: 10.1016/j.jncc.2024. 11.006.

3. McLemore MR. Gardasil: introducing the new human papillomavirus vaccine. Clin J Oncol Nurs 2006; 10 (5): 559–560. doi: 10.1188/06.CJON.559–560.

4. PSP ČR. Seminář: Aktuální data o proočkovanosti populace se zaměřením na očkování proti HPV. 2023 [online]. Available from: https: //public.psp.cz/zprava/18395.

5. RCOG. Progress in Cervical Screening in the UK (Scientific Impact Paper No. 7). 2025 [online]. Available from: https: //www.rcog.org.uk/guidance/browse-all-guidance/scientific-impact-papers/progress-in-cervical-screening-in-the-uk-scientific-impact-paper-no-7/.

6. Arbyn M, Buntinx F, Van Ranst M et al. Virologic versus cytologic triage of women with equivocal Pap smears: a meta-analysis of the accuracy to detect high-grade intraepithelial neoplasia. J Natl Cancer Inst 2004; 96 (4): 280–293. doi: 10.1093/jnci/djh037.

7. Sehnal B, Sláma J. Jak dále ve screeningu karcinomu děložního hrdla? Ceska Gynekol 2020; 85 (4): 236–243.

8. European guidelines for quality assurance in cervical cancer screening –⁠ publications Office of the EU. 2025 [online]. Available from: https: //op.europa.eu/en/publication-detail/-/publication/a41a4c40-0626-4556-af5b-2619dd1d5ddc.

9. Comprehensive cervical cancer control. A guide to essential practice –⁠ second edition. 2025 [online]. Available from: https: // www.who.int/publications/i/item/97892415 48953.

10. Arbyn M, Ronco G, Anttila A et al. Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer. Vaccine 2012; 30 (Suppl 5): F88–F99. doi: 10.1016/j.vaccine.2012.06.095.

11. Bergengren L, Ryen L, Flodström C et al. Effectiveness and costs of an implemented primary HPV cervical screening programme in Sweden –⁠ a population based cohort study. Prev Med Rep 2021; 25 : 101675. doi: 10.1016/j.pmedr.2021.101675.

12. Ogilvie GS, van Niekerk D, Krajden M et al. Effect of screening with primary cervical HPV testing vs cytology testing on high-grade cervical intraepithelial neoplasia at 48 months: the HPV FOCAL randomized clinical trial. JAMA 2018; 320 (1): 43–52. doi: 10.10001/jama.2018. 7464.

13. Kitchener HC, Almonte M, Thomson C et al. HPV testing in combination with liquid--based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial. Lancet Oncol 2009; 10 (7): 672–682. doi: 10.1016/S1470-2045 (09) 70156-1.

14. Rijkaart DC, Berkhof J, Rozendaal L et al. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial. Lancet Oncol 2012; 13 (1): 78–88. doi: 10.1016/S1470-20 45 (11) 70296-0.

15. Konusevska A. European Cancer Organisation. Recommendations on Screening 2020. 2025 [online]. Available from: https: //www.europeancancer.org/content/recommendations-on-screening-a-four-step-plan-for-eliminating-hpv-cancers-in-europe.html.

16. Screening för livmoderhalscancer –⁠ Rekommendation om att erbjuda screening –⁠ Slutversion 2022. 2025 [online]. Available from: https: //www.socialstyrelsen.se/publikationer/screening-for-livmoderhalscancer--rekommendation-om-att-erbjuda-screening--slutversion-2022-2022 -⁠ 2-7758/.

17. Maver PJ, Poljak M. Primary HPV-based cervical cancer screening in Europe: implementation status, challenges, and future plans. Clin Microbiol Infect 2020; 26 (5): 579–583. doi: 10.1016/j.cmi.2019.09.006.

18. RIVM. Information about cervical cancer screening. 2025 [online]. Available from: https: //www.rivm.nl/en/cervical-cancer-screening-programme/information-materials.

19. Health Screening Cervical Cancer. 2025 [online]. Available from: https: //www.bevolkingsonderzoeknederland.nl/en/cervical-cancer/ the-screening/.

20. INAMI. Détection du cancer du col de l’utérus en Belgique –⁠ Introduction du test HPV comme test de dépistage primaire. 2025 [online]. Available from: https: //www.inami.fgov.be/fr/actualites/detection-du-cancer-du-col-de -⁠ l-uterus-en-belgique-introduction-du-test-hpv-comme-test-de-depistage -⁠ primaire.

21. Ellis LB, Bowden SJ, Lyons D et al. SIP 7: Progress in Cervical Cancer Prevention in the UK (2025 Second Edition). BJOG 2025 [online]. Available from: https: //onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.18262.

22. GOV.UK. Cervical screening care pathway. 2025 [online]. Available from: https: //www.gov.uk/government/publications/cervical-screening-care-pathway/cervical-screening-care-pathway.

23. Hamers FF, Poullié AI, Arbyn M. Updated evidence-based recommendations for cervical cancer screening in France. Eur J Cancer Prev 2022; 31 (3): 279–286. doi: 10.1097/CEJ.00000000000000701.

24. Seweryn M, Leszczyńska A, Jakubowicz J et al. Cervical cancer in Poland –⁠ epidemiology, prevention, and treatment pathways. Oncology in Clinical Practice 2024. 2025 [online]. Available from: https: //journals.viamedica.pl/oncology_in_clinical_practice/article/view/ 100857.

25. NOISK.sk. Cervical cancer screening. 2025 [online]. Available from: https: //www.noisk.sk/screening/professionals/cervical-cancer-screening.

26. Pataki J, Szőllősi GJ, Sárváry A et al Factors associated with cervical cancer screening attendance in Hungary based on the European health interview Survey. Int J Public Health 2024; 69 : 1607509. doi: 10.3389/ijph.2024.16 07509.

27. d.o.o A. ZORA. Slovenian National Cervical Cancer Screening Programme and Registry. 2025 [online]. Available from: https: //zora.onko-i.si/en.

28. Stankūnas M, Pärna K, Tisler A et al. Cervical cancer in the baltic states: can intelligent and personalized cancer screening change the situation? Acta Med Litu 2022; 29 (1): 19–26. doi: 10.15388/Amed.2022.29.1.18.

29. Krebs. Cervical cancer. 2025 [online]. Available from: https: //www.krebsdaten.de/Krebs/ EN/Content/Cancer_sites/Cervical_cancer/cervical_cancer_node.html.

30. MU IL. Cervix.cz. 2025 [online]. Available from: https: //www.cervix.cz/cs/o-programu/.

31. Kinkorová Luňáčková I. Ústní sdělení: Proč někdy nekorelují cytologické nálezy a výsledky HPV testů? Praha: 17. konference Sekce kolposkopie a cervikální patologie ČGPS ČLS JEP, 28.–30. 11. 2025.

32. Diaz M, Moriña D, Rodríguez-Salés V et al. Moving towards an organized cervical cancer screening: costs and impact. Eur J Public Health 2018; 28 (6): 1132–1138. doi: 10.1093/eur pub/cky061.

ORCID autorů

N. Janovská 0009-0006-5832-7702

L. Rob 0000-0003-3770-651X

B. Sehnal 0000-0003-2622-2181

K. Robová 0009-0000-8778-0465

M. J. Halaška 0000-0001-6055-2569

H. Robová 0000-0002-6136-7602

Doručeno/Submitted: 27. 8. 2025

Přijato/Accepted: 22. 10. 2025

MUDr. Nikola Janovská

Gynekologicko-porodnická klinika

3. LF UK a FNKV