Cervical cancer screening

What is cervical cancer?

Cervical cancer is a serious illness. In Denmark, approximately 365 women are diagnosed with cervical cancer every year. Half of them under the age of 50.

Cervical cancer develops from abnormal cervical cells (dysplasia) often arising from a HPV (Human Papilloma Virus) infection. Abnormal cervical cells are not cancer but pre-cancerous changes that can be treated.

Women with cervical abnormalities rarely experience any symptoms. However, if you do experience gyneacological symptoms, you should always contact your GP (General Practitioner). This also applies if you follow the screening programme for cervical cancer regularly.

Screening for cervical cancer

The purpose of cervical cancer screening is to detect abnormal cervical cells or HPV infection. Early detection of abnormalities improves the chance of initiating effective treatment, before cervical cancer develops.

Women aged 23 to 64 will receive an invitation to voluntary cervical cancer screening at regular intervals every 3rd or 5th year (based on age and birthdate).

The Danish Health Authorities recommend participation in cervical cancer screening, but it is important that you make your own decision.

HPV vaccinated women are also recommended to participate in screening for cervical cancer, as the vaccination does not cover all carcinogenic HPV types.

Read more about pros and cons of participating in the cervical cancer screening programme

Withdraw from the screening programme

If you want to withdraw temporarily or permanently from the screening programme, you can do so here:

• Withdraw from the screening programme (Sundhed.dk-In Danish)

or

• Contact the Department of Public Health Programmes

It is always possible to regret your withdrawal by contacting the Department of Public Health Programmes.

If you have had a full hysterectomy and therefore do not have a cervix, you are advised to withdraw from the screening programme.

Invitation to screening

You will receive the first invitation short after you turn 23. You will receive you last invitation between the age of 60 to 64 years.

The frequency of invitations is based on age and date of birth:

• 23 to 29-year-old women are invited every 3rd year
• 30 to 49-year-old women are invited every 3rd year if they have an even date of birth
• 30 to 49-year-old women are invited every 5th year if they have an odd date of birth
• 50 to 64-year-old women are invited every 5th year.

Change of gender: If you have a cervix, but a male civil registration number, invitations to screening is not sent automatically. We recommend that you screenings are planned in corporation with your GP.

You are always welcome to contact Department of Public Health Programmes for information on when to expect an invitation to cervical cancer screening

Book screening appointment

The invitation encourages women to book a screening appointment at their GP's office.

Examination during pregnancy and period

It you are pregnant or have your period, we recommend that you reschedule your appointment.

Reminders

Non-participants will receive a reminder 3 and 6 months after the initial invitation. Only in the second reminder, women will be offered the opportunity to order a HPV self-sampling kit.

Invitations and reminders are sent by Digital Post.

Read more about Digital Post

Screening for cervical cancer can be performed in two different ways: 

Screening examination performed by your GP

If the screening is performed at your GP's office, the GP or nurse will collect a cell-sample from the cervix during a gynaecological examination.

The gynaecological examination usually takes 5-10 minutes. The cell-sample will be analysed for abnormal cervical cells (dysplasia) and/or HPV.

Before leaving the GP, you should agree with your GP or nurse how to get the screening result.

Screening performed by self-sampling

If the screening is done using a self-sampling kit at home, you will receive a guidance on how to perform the test and how to handle the sample. When returned to the laboratory the sample is analysed for HPV.

Results of the screening examination

In most cases the screening test results are available within 4 weeks. How screening test results are conveyed depends on how the screening is performed:

• At the GP
  If the screening is performed by a GP, you will receive the screening test result by contacting the GP's office. However, your GP may also have ordered that the test result is sent to you by Digital Post. Therefore, it is always advisable that you confer with your GP, at the time of examination, how you prefer to receive the screening results.
• With a self-sampling kit
  If the screening is performed using a self-sampling kit at home, the test result will be sent by Digital Post. If consented to, your GP will receive a copy of the test result. If your test shows signs of HPV you will be recommended to schedule an ordinary screening appointment performed by your GP.

There are four possible results: 

• A normal screening result
  If the test result is normal, the test shows no signs of abnormal cervical cells (dysplasia) and/or HPV. In these cases, additional follow-up examinations are not required. You will be advised to continue participation in the screening programme.
• A normal screening result with follow-up recommendation
  Despite a normal screening test result, some women are recommended additional examinations. For example, this might be the case when previous test results have shown abnormal cervical cells. If so, you must plan follow-up together with your GP.
• An abnormal screening result
  If the screening test result shows signs of abnormal cervical cells (dysplasia) and/or HPV, you will be advised to consult your GP to plan and book additional examinations.
• An inadequate result
  If the screening result is inadequate, it was not possible to evaluate the sample, for instance due to technical issues. In these cases, you will be recommended a new screening examination.

If you do not receive your screening result, we recommend to consult the doctor who made the examination. If you do not receive a screening result after HPV self-sampling, we recommend, that you contact the Department of Public Health Programmes.

You will not be called to an additional examination automatically. Your GP must carry out or refer you to relevant examinations in accordance with your screening examination results. You are advised to plan and book additional examinations in corporation with your GP.

Additional examination at your GP

If you have milder abnormal cervical cells or a HPV infection, it may be sufficient with an additional examination at your GPs office. Most often this examination is carried out in the same way as the screening examination.  

Additional examination by a gynaecologist

If you need an examination by a gynaecologist you are advised to contact your GP to get a referral to a gynaecologist. The gynaecologist may perform an extended gynaecological examination (colposcopy) during which your cervix can be examined in greater detail for signs of disease. It is possible to be accompanied by a friend or a relative.

For information in other languages (for instance Urdu, Arabic, Turkish) about the Danish cancer screening programmes, see the following links at sst.dk.

Screening for cervical cancer [sst.dk]