scholarly journals Effect of introducing human papillomavirus genotyping into real-world screening on cervical cancer screening in China: a retrospective population-based cohort study

2021 ◽  
Vol 13 ◽  
pp. 175883592110109
Author(s):  
Binhua Dong ◽  
Huachun Zou ◽  
Xiaodan Mao ◽  
Yingying Su ◽  
Hangjing Gao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cox Regression ◽  
Intraepithelial Neoplasia ◽  
Population Based ◽  
Hpv Genotyping ◽  
Cytology Screening

Background: China’s Fujian Cervical Pilot Project (FCPP) transitioned cervical cancer screening from high-risk human papillomavirus (HR-HPV) nongenotyping to genotyping. We investigated the clinical impact of this introduction, comparing performance indicators between HR-HPV genotyping combined with cytology screening (HR-HPV genotyping period) and the previous HR-HPV nongenotyping combined with cytology screening (HR-HPV nongenotyping period). Methods: A retrospective population-based cohort study was performed using data from the FCPP for China. We obtained data for the HR-HPV nongenotyping period from 1 January 2012 to 31 December 2013, and for the HR-HPV genotyping period from 1 January 2014 to 31 December 2016. Propensity score matching was used to match women from the two periods. Multivariable Cox regression was used to assess factors associated with cervical intraepithelial neoplasia of grade 2 or worse (CIN2+). The primary outcome was the incidence of CIN2+ in women aged ⩾25 years. Performance was assessed and included consistency, reach, effectiveness, adoption, implementation and cost. Results: Compared with HR-HPV nongenotyping period, in the HR-HPV genotyping period, more CIN2+ cases were identified at the initial screening (3.06% versus 2.32%; p < 0.001); the rate of colposcopy referral was higher (10.87% versus 6.64%; p < 0.001); and the hazard ratio of CIN2+ diagnosis was 1.64 (95% confidence interval, 1.43–1.88; p < 0.001) after controlling for health insurance status and age. The total costs of the first round of screening (US$66,609 versus US$65,226; p = 0.293) were similar during the two periods. Higher screening coverage (25.95% versus 25.19%; p = 0.007), higher compliance with age recommendations (92.70% versus 91.69%; p = 0.001), lower over-screening (4.92% versus 10.15%; p < 0.001), and reduced unqualified samples (cytology: 1.48% versus 1.73%, p = 0.099; HR-HPV: 0.57% versus 1.34%, p < 0.001) were observed in the HR-HPV genotyping period. Conclusions: Introduction of an HR-HPV genotyping assay in China could detect more CIN2+ lesions at earlier stages and improve programmatic indicators. Evidence suggests that the introduction of HR-HPV genotyping is likely to accelerate the elimination of cervical cancer in China.

scholarly journals Psychiatric morbidity and cervical cancer screening: a retrospective population-based case–cohort study

CMAJ Open ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. E134-E141
Author(s):  
Michael Ouk ◽  
Jodi D. Edwards ◽  
Jessica Colby-Milley ◽  
Alexander Kiss ◽  
Walter Swardfager ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Psychiatric Morbidity ◽  
Population Based

scholarly journals Cervical cancer screening uptake among HIV-positive women in Ontario, Canada: A population-based retrospective cohort study

2018 ◽  
Vol 107 ◽  
pp. 14-20 ◽  
Author(s):  
Ann N. Burchell ◽  
Claire E. Kendall ◽  
Stephanie Y. Cheng ◽  
Aisha Lofters ◽  
Michelle Cotterchio ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Hiv Positive ◽  
Screening Uptake ◽  
Hiv Positive Women

scholarly journals Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mette Mindedahl Jespersen ◽  
Berit Bargum Booth ◽  
Lone Kjeld Petersen
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Cancer Screening ◽  
Intraepithelial Neoplasia ◽  
Relative Increase ◽  
Low Grade ◽  
Squamocolumnar Junction ◽  
Study Participants ◽  
Cytology Screening

Abstract Background Controversy surrounds whether women with low-risk cytology screening results but a normal colposcopic assessment should have random biopsies taken. The aim of this study was to determine the yield of CIN2+ from one to four cervical biopsies in women with cytology of LSIL or ASCUS and a normal colposcopic impression. Methods Between January 2017 and September 2020, women over 18 years old referred for colposcopic examination due to either an abnormal smear (ASCUS+) or follow-up after previous cervical intraepithelial neoplasia (CIN) were invited to participate in the study. All study participants underwent colposcopic examination and had four biopsies taken. The biopsies were analyzed separately. Results In total, 1327 women with abnormal cervical cancer screening results or attending follow-up after a previous CIN diagnosis were enrolled in the study and examined by colposcopy. Of these, 173 were newly referred with cytology of LSIL or ASCUS and had a normal colposcopic impression and four adequate biopsies. Of these, 22.0% were diagnosed with CIN2+. When combining the results of the four biopsies, we found a 100% relative increase in CIN2+ cases compared to using only one biopsy (from 11.0% to 22.0%, P = 0.006). Conclusion As we found CIN2+ from random cervical biopsies in 22.0% of women with cytology of LSIL or ASCUS who had a normal colposcopic impression, we advocate performing four random cervical biopsies at the squamocolumnar junction in such women. Trial registration NCT04249856, January 31 2020 (retrospectively registered).

scholarly journals Screening participation after a false positive result in organized cervical cancer screening: a nationwide register-based cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pernille Thordal Larsen ◽  
Susanne Fogh Jørgensen ◽  
Mette Tranberg ◽  
Sisse Helle Njor
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
False Positive ◽  
Intraepithelial Neoplasia ◽  
Cervical Cytology ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Screening Participation ◽  
Cancer Screening Participation

Abstract Our aim was to investigate whether receiving a false positive (FP) cervical cytology result affected subsequent cervical cancer screening participation. This Danish nationwide register-based cohort study included 502,380 women aged 22.5–45 attending cervical cancer screening in 2012–2014 with a normal (n = 501,003) or FP (n = 1,377) cytology screening result. A FP result was defined as a cervical cytology showing high grade cytological abnormalities followed by a normal or ‘Cervical Intraepithelial Neoplasia grade 1’ biopsy result. Women were categorized as subsequent participants if they had a cervical cytology within 24–42 months after their last screening or surveillance test. We compared subsequent participation among women with a normal versus a FP result, using odds ratios including 95% confidence intervals. Participation was slightly higher among women with FP results than among women with normal results (71.5% vs. 69.2%, p = 0.058). After adjustment for age and screening history, women with FP results participated significantly more than women with normal results (OR: 1.19, 95% CI 1.06–1.35). Women receiving a FP result did not participate less in subsequent cervical cancer screening than women receiving a normal result. In fact, the use of opportunistic screening seemed to be increased among women receiving a FP result.

scholarly journals Correction: Barriers to and Facilitators of Compliance with Clinic-Based Cervical Cancer Screening: Population-Based Cohort Study of Women Aged 23-60 Years

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0135534 ◽  
Author(s):  
Ellinor Östensson ◽  
Susanna Alder ◽  
K. Miriam Elfström ◽  
Karin Sundström ◽  
Niklas Zethraeus ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Population Based ◽  
Screening Population

scholarly journals Barriers and attitudes towards cervical cancer screening in primary healthcare in Poland - doctors’ perspective

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Katarzyna Nessler ◽  
Francis Ball ◽  
Sze Kay Florence Chan ◽  
Michal Chwalek ◽  
Anna Krztoń-Królewiecka ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Financial Incentives ◽  
Screening Program ◽  
Population Based ◽  
Pap Smears ◽  
Cross Sectional ◽  
Eu Member States ◽  
Cytology Screening

Abstract Background Healthcare systems have adopted different strategies to reduce the burden of cervical cancer. In Poland, a population-based screening program was implemented in 2006, leading to a downward trend in cervical cancer burden. However, screening rates are still low in relation to other EU member states. In Poland, Pap smears are mainly performed by gynecologists rather than Primary Health Care (PHC) physicians. Little is known about the experiences and attitudes of the latter regarding cervical cancer screening in a PHC setting. Methods A cross-sectional questionnaire-based survey was carried out among 43 PHC physicians from the Malopolska region in Poland. Barriers and attitudes towards cytology in a PHC setting were evaluated. Results Approximately 35% of surveyed physicians reported having experience in performing cytology. Almost 75% of PHC physicians lacked the necessary equipment in their office to perform the screening. None of the studied physicians performed Pap smears in their office at the time. The reasons included: shortage of competence (78.57%) and time (69.05%), the perception of Pap smears as a task for gynecologists (69.05%), the lack of financial incentives (61.90%), and the belief that their patients would be unwilling to undergo the test in their PHC physician’s office (33.33%). More than three quarters (76.74%) declared they would be ready to perform Pap smears if the tests were additionally paid. No significant associations between PHC physicians’ characteristics and their willingness to perform cytology screening were found. Conclusion The primary barrier to perform Pap smears by PHC physicians does not lie in their personal reluctance but in the organization of the healthcare system. Provision of required training and proper funding allocation can likely improve the screening rate of cervical cancer in Poland.

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