Sweden aspires to be the first country to eradicate the human papillomavirus, which covers viruses that are linked to several cancers, including cervical cancer in women. The theory of the strategy is that a high percentage of immunization rates and wide coverage of screening will eradicate it. The World Health Organization lists cervical cancer as the fourth most common in women around the world. The Swedish government initiated the Cervical Cancer Eradication Project in 2021 with a national initiative in cooperation with cancer researchers, regional health authorities, and the Swedish Cancer Society, to achieve this ambitious goal.
Joakim Dillner, head of the Cervical Cancer Elimination Centre at the Karolinska Institute, said that eradicating this kind of cancer is something monumental and would set precedence globally. Sweden started making its national strategy in relation to free HPV vaccination, first from 2012 targeting girls aged 10-12, then starting it for boys in 2020. Vaccination coverage reached up to 90% for girls and up to 85% for boys up to now.
The new HPV vaccine offers close to 90 percent protection against cervical cancer, based on prevention of nine cancer-causing strains of HPV as well as some strains of the viruses that previous vaccines have not. In light of this consideration for equity, Sweden also offers free catch-up vaccines to females born from 1994-1999, who were not provided with the new vaccine. Dillner emphasizes a moral imperative to protect women with the most recent vaccines possible.
Sweden has taken some aggressive steps to increase the take-up of vaccines, such as pop-up vaccination clinics. In November, 600 free vaccines were administered at the local cinemas in just two hours. According to Ulrika Årehed Kågström, secretary general of the Swedish Cancer Society, if 70% of women in the catch-up age get vaccinated, Sweden could even eradicate cervical cancer by 2027.
The national eradication project is divided into two phases: vaccination and mass screening. The goal is to identify and treat pre-existing HPV infections, reducing the virus’s ability to spread. Starting in 2025, the program will focus on screening to detect infections and prevent future cases of cervical cancer. However, there is some hesitancy among older women, who worry that the vaccine is less effective after sexual activity. Experts assure that the vaccine remains effective for HPV-negative individuals, with screening to follow for those who test positive.
Eliminating HPV and cervical cancer is a costly endeavor, with Sweden allocating approximately €350,000 towards the project this year. Dillner cautioned that while neighboring countries like Denmark may consider reducing screening efforts, Sweden’s approach must involve continuous vigilance, as enhanced screening can improve cancer prevention even when HPV transmission rates are low.
