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Redefining Cytotechnologist Practice in Sweden : National Survey on Workload, Expanded Roles, and Future Competency Needs

Basic, Vladimir ; Stacke, Karin A ; Rexaj, Genta ; Kirova, Nadi LU ; Sanchez Benito, Maria ; Englund, Belinda ; Omholt, Katarina and Mansour, Mohammed S I LU orcid (2026) In Acta Cytologica p.1-24
Abstract

INTRODUCTION: Cytotechnologists have long been central to cervical cancer screening, although their education and job responsibilities differ markedly across countries. The adoption of primary HPV testing has substantially reshaped cytotechnology workforce needs and professional roles. In Sweden, however, no comprehensive overview of these changes exists. This study therefore examined cytotechnologists' training, job tasks, and how HPV testing has affected their daily work and practice patterns.

METHODS: We conducted a nationwide survey of Swedish cytology laboratories using an electronic questionnaire developed by the Board of the Swedish Society of Cytotechnologists. The 84‑item instrument addressed workload, diagnostic tasks,... (More)

INTRODUCTION: Cytotechnologists have long been central to cervical cancer screening, although their education and job responsibilities differ markedly across countries. The adoption of primary HPV testing has substantially reshaped cytotechnology workforce needs and professional roles. In Sweden, however, no comprehensive overview of these changes exists. This study therefore examined cytotechnologists' training, job tasks, and how HPV testing has affected their daily work and practice patterns.

METHODS: We conducted a nationwide survey of Swedish cytology laboratories using an electronic questionnaire developed by the Board of the Swedish Society of Cytotechnologists. The 84‑item instrument addressed workload, diagnostic tasks, ancillary testing, digital cytology, job satisfaction, and managerial assessments. Responses were summarized descriptively.

RESULTS: Screening of gynecologic (86%) and non‑gynecologic specimens (89%) remained widely practiced among cytotechnologists, together with involvement in rapid on‑site evaluation (48%), quality assurance activities (41%), and fine‑needle aspiration assessment (55%). The transition to HPV‑primary screening was associated with reductions exceeding 50% in cervical cytology volumes and contributed to marked workforce pressures; 30% cytotechnologists reported assuming novel responsibilities, 81% of laboratories reported recent cytotechnologist attrition, whereas only 15% anticipated new recruitment. Adoption of digital cytology remained limited (6%), and no laboratory reported the use of artificial intelligence-based tools. Interest in expanded professional roles was high among cytotechnologists (93%) and was substantially supported by managers (88%). Concerns regarding job satisfaction were evident, with 19% of cytotechnologists indicating an intention to leave their position within the forthcoming year.

CONCLUSION: Sustaining cytology services will require proactive workforce planning, competency‑based upskilling, role diversification, and strategic adoption of digital technologies.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Acta Cytologica
pages
24 pages
publisher
Karger
external identifiers
  • pmid:41770652
ISSN
0001-5547
DOI
10.1159/000551322
language
English
LU publication?
yes
additional info
The Author(s). Published by S. Karger AG, Basel.
id
e4c66996-cf2c-4605-893b-73d74d795602
date added to LUP
2026-03-07 08:34:45
date last changed
2026-03-09 08:26:28
@article{e4c66996-cf2c-4605-893b-73d74d795602,
  abstract     = {{<p>INTRODUCTION: Cytotechnologists have long been central to cervical cancer screening, although their education and job responsibilities differ markedly across countries. The adoption of primary HPV testing has substantially reshaped cytotechnology workforce needs and professional roles. In Sweden, however, no comprehensive overview of these changes exists. This study therefore examined cytotechnologists' training, job tasks, and how HPV testing has affected their daily work and practice patterns.</p><p>METHODS: We conducted a nationwide survey of Swedish cytology laboratories using an electronic questionnaire developed by the Board of the Swedish Society of Cytotechnologists. The 84‑item instrument addressed workload, diagnostic tasks, ancillary testing, digital cytology, job satisfaction, and managerial assessments. Responses were summarized descriptively.</p><p>RESULTS: Screening of gynecologic (86%) and non‑gynecologic specimens (89%) remained widely practiced among cytotechnologists, together with involvement in rapid on‑site evaluation (48%), quality assurance activities (41%), and fine‑needle aspiration assessment (55%). The transition to HPV‑primary screening was associated with reductions exceeding 50% in cervical cytology volumes and contributed to marked workforce pressures; 30% cytotechnologists reported assuming novel responsibilities, 81% of laboratories reported recent cytotechnologist attrition, whereas only 15% anticipated new recruitment. Adoption of digital cytology remained limited (6%), and no laboratory reported the use of artificial intelligence-based tools. Interest in expanded professional roles was high among cytotechnologists (93%) and was substantially supported by managers (88%). Concerns regarding job satisfaction were evident, with 19% of cytotechnologists indicating an intention to leave their position within the forthcoming year.</p><p>CONCLUSION: Sustaining cytology services will require proactive workforce planning, competency‑based upskilling, role diversification, and strategic adoption of digital technologies.</p>}},
  author       = {{Basic, Vladimir and Stacke, Karin A and Rexaj, Genta and Kirova, Nadi and Sanchez Benito, Maria and Englund, Belinda and Omholt, Katarina and Mansour, Mohammed S I}},
  issn         = {{0001-5547}},
  language     = {{eng}},
  month        = {{03}},
  pages        = {{1--24}},
  publisher    = {{Karger}},
  series       = {{Acta Cytologica}},
  title        = {{Redefining Cytotechnologist Practice in Sweden : National Survey on Workload, Expanded Roles, and Future Competency Needs}},
  url          = {{http://dx.doi.org/10.1159/000551322}},
  doi          = {{10.1159/000551322}},
  year         = {{2026}},
}