Photo credit: Jorunn Valle Nilsen
Every January, Norway launches the #SjekkDeg campaign, a nationwide initiative aimed at increasing awareness about cervical cancer and encouraging women to participate in regular cervical cancer screening. The name, which translates to “#CheckYourself,” is a clear and compelling call to action. Since its inception, #SjekkDeg has played a crucial role in informing the public and increasing participation in the Norwegian Cervical Cancer Screening Program.
The #SjekkDeg campaign was established in 2015, by Thea Steen, a 26-year-old Norwegian journalist diagnosed with cervical cancer. Rather than keeping her struggle private, Thea shared her experience publicly, urging other women to attend regular screenings. Her powerful message gained national attention and motivated the Norwegian Cancer Society and Cancer Registry of Norway to formalise the #SjekkDeg campaign. Today, it stands as a testament to how personal storytelling can drive public health outcomes.
The success of the #SjekkDeg campaign relies heavily on effective communication and public engagement. Each year, the campaign employs a multi-channel marketing strategy to reach a broad audience and encourage participation. Key components of the marketing strategy include:
Since its launch in 2015, the #SjekkDeg campaign has contributed to a significant increase in cervical cancer screening participation rates in Norway. Thousands of women have undergone screening as a direct result of the campaign’s efforts, leading to the early detection of precancerous conditions and a reduction in cervical cancer cases.
The #SjekkDeg model provides key insights for anyone planning similar campaigns:
Commercially available HPV assays used in screening detect 14 high-risk (hr) HPV genotypes. While HPV testing is more sensitive than cytology, detecting all 14 types together does not differentiate between transient infections and persistent infections that can lead to cancer.
When HPV-based screening was implemented in 2019, all hrHPV-positive women with abnormal cytology were referred for colposcopy and biopsy, leading to a 60% increase in colposcopy referrals. This created a suboptimal clinical management system with low predictive value, excessive use of health care services, and distress among women. DOI: 10.1158/1055-9965.EPI-22-0340
In our effort to calibrate the follow-up algorithm, we relied on the premise that each of the 14 distinct hr HPV genotypes possesses its own unique carcinogenic potential and cervical cancer risk profile. More than 3000 hrHPV positive women were assessed for risk of cervical precancers and cancers while separating the most carcinogenic genotypes, HPV16 and 18, from the pool of the remaining hrHPV types. DOI: 10.1038/s41416-020-0790-1
As a result, this new screening algorithm reduced unnecessary colposcopy referrals with biopsy for women with lower precancer or cancer risk. Based on our research, the follow-up algorithm for HPV-positives was changed in July 2018.
Ongoing research aims to develop more effective clinical algorithms for managing HPV-positive women. Our focus includes methylation markers, the combination of methylation and HPV genotyping, and the integration of methylation with cytology. Several studies are also evaluating the most suitable screening strategies for HPV-vaccinated populations. Additionally, research into risk-based screening seeks to optimise cancer prevention by tailoring follow-up strategies to individual risk profiles.
CervicalScreen Norway demonstrates how evidence-based strategies can enhance cervical cancer screening. The integration of HPV self-sampling has improved access, particularly for underserved groups, and research suggests that direct mailing of test kits could further boost participation.
Ongoing efforts focus on optimising risk-based screening, refining triage protocols for HPV-positive individuals, and tailoring strategies for HPV-vaccinated populations. By sharing our research and experiences, we aim to support European countries in strengthening their screening programs and advancing cervical cancer prevention.
The general objective of EUCanScreen is to assure sustainable implementation of high-quality screening for breast, cervical and colorectal cancers, as well as implementation of the recently recommended screening programs – for lung, prostate and gastric cancers. EUCanScreen will facilitate the reduction of cancer burden and achieving equity across the EU.
This project has received funding from the European Union’s EU4HEALTH Programme under the Grant Agreement no 101162959