在经过良好筛查的人群中，大多数宫颈癌都是由筛查不充分的一小部分女性引起的。本研究旨在评估基于登记的癌症风险评估是否可用于提高高危女性的筛查强度。国家宫颈筛查登记处确定了瑞典 28,689 名女性居民，她们要么以前没有接受过宫颈筛查，要么筛查历史表明存在高风险。我们通过短信和/或信件邀请这些女性订购免费的人乳头瘤病毒 (HPV) 自我采样套件。瑞典国家 HPV 参考实验室进行了扩展 HPV 基因分型，并将高危 HPV 阳性女性转诊给当地妇科医生。共有 3691/28,689 (12.9%) 名女性订购了自我采样套件，10.0% (2853/28,689) 名女性返回了样本进行检测。从未参加过筛查的女性的参与率虽然有所提高，但仍较低。其他高危人群中高达 22.5% 的女性参加了活动。 8.3% 的样本中检测到高危 HPV 类型。高危 HPV 阳性女性 (238/2853) 未经进一步分诊就被转诊，并且在 36/158 (23%) 的活检女性中在组织病理学中检测到严重宫颈癌前期或癌症 (HSIL)。重复邀请会带来适度的额外参与。通过个人邀请在全国范围内联系宫颈癌高危女性订购 HPV 自我采样试剂盒，结果 CIN2 检出率较高。改进风险分层筛查策略的进一步努力应致力于提高（i）风险分层算法的精确度，（ii）女性参与的便利性，以及（iii）确保筛查呈阳性的女性得到跟踪。 © 2024 作者。约翰·威利出版的《国际癌症杂志》

In well-screened populations, most cervical cancers arise from small groups of women with inadequate screening. The present study aims to assess whether registry-based cancer risk assessment could be used to increase screening intensity among high-risk women. The National Cervical Screening Registry identified the 28,689 women residents in Sweden who had either no previous cervical screening or a screening history indicating high risk. We invited these women by SMS and/or physical letter to order a free human papillomavirus (HPV) self-sampling kit. The Swedish national HPV reference laboratory performed extended HPV genotyping and referred high-risk HPV-positive women to their regional gynecologist. A total of 3691/28,689 (12.9%) women ordered a self-sampling kit and 10.0% (2853/28,689) returned a sample for testing. Participation among women who had never attended screening was low, albeit improved. Up to 22.5% of women in other high-risk groups attended. High-risk HPV types were detected in 8.3% of samples. High-risk HPV-positive women (238/2853) were referred without further triaging and severe cervical precancer or cancer (HSIL+) in histopathology were detected in 36/158 (23%) of biopsied women. Repeat invitations gave modest additional participation. Nationwide contacting of women with high risk for cervical cancer with personal invitations to order HPV self-sampling kits resulted in high yield of detected CIN2+. Further efforts to improve risk-stratified screening strategies should be directed to improving (i) the precision of the risk-stratification algorithm, (ii) the convenience for the women to participate and, (iii) ensuring that screen-positive women are followed-up.© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.