New screening technologies

In the year 1999, automation-assisted cytology (Papnet®) was implemented into service screening in six screening laboratories. Another novel screening technology was launched within the Finnish service screening during 2003–2004 in nine municipalities of Southern Finland. Here the screening tests are HPV DNA tests instead of the traditional Pap test. It has been observed this far that HPV DNA screening finds more CIN lesions than conventional screening. However, mild- and moderate-grade lesions and also a part of the high-grade lesions would not progress even if left untreated, which results in overtreatment. Because transient HPV infections are very common among women under 35 years, HPV DNA screening is not recommended for women of this age group. HPV-testing also leads to an increase in the number of follow-up recommendations, which causes both additional costs and increases the harms of screening. 

Both new technologies have been applied into service screening in a randomised setting. Thus the effectiveness can be studied by comparing the new tests with conventional screening. In the future it will be estimated whether these new technologies are better than conventional Pap test -based screening in decreasing the incidence and mortality of cervical cancer. However, in Finland, the additional benefit of new technologies will probably remain small because of a very well functioning screening programme.