title: 50 years of screening in the Nordic countries: quantifying the effects on cervical cancer incidence.
abstract: BACKGROUND
  Nordic countries' data offer a unique possibility to evaluate the long-term benefit of cervical cancer screening in a context of increasing risk of human papillomavirus infection.
  
  
  METHODS
  Ad hoc-refined age-period-cohort models were applied to the last 50-year incidence data from Denmark, Finland, Norway and Sweden to project expected cervical cancer cases in a no-screening scenario.
  
  
  RESULTS
  In the absence of screening, projected incidence rates for 2006-2010 in Nordic countries would have been between 3 and 5 times higher than observed rates. Over 60,000 cases or between 41 and 49% of the expected cases of cervical cancer may have been prevented by the introduction of screening in the late 1960s and early 1970s.
  
  
  CONCLUSIONS
  Our study suggests that screening programmes might have prevented a HPV-driven epidemic of cervical cancer in Nordic countries. According to extrapolations from cohort effects, cervical cancer incidence rates in the Nordic countries would have been otherwise comparable to the highest incidence rates currently detected in low-income countries.
authors.affiliation: International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France.
authors.forename: S
authors.initials: S
authors.lastname: Vaccarella
authors.affiliation: International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France.
authors.forename: S
authors.initials: S
authors.lastname: Franceschi
authors.affiliation: Department of Documentation & Quality, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark.
authors.forename: G
authors.initials: G
authors.lastname: Engholm
authors.affiliation: Cancer Registry of Norway, P.O. box 5313 Majorstuen, Oslo N-0304, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Lönnberg
authors.affiliation: Swedish Cancer Registry, National Board of Health and Welfare, S-106 30 Stockholm, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.affiliation: International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France.
authors.forename: F
authors.initials: F
authors.lastname: Bray
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods; D030361:Papillomavirus Infections / Q000453:epidemiology; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000821:virology