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High lifetime probability of screen-detected cervical abnormalities

OBJECTIVE: Regular screening and follow-up is an important key to cervical cancer prevention; however, screening inevitably detects mild or borderline abnormalities that would never progress to a more severe stage. We analysed the cumulative probability and recurrence of cervical abnormalities in th...

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Autores principales: Pankakoski, Maiju, Heinävaara, Sirpa, Sarkeala, Tytti, Anttila, Ahti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661699/
https://www.ncbi.nlm.nih.gov/pubmed/28073308
http://dx.doi.org/10.1177/0969141316685740
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author Pankakoski, Maiju
Heinävaara, Sirpa
Sarkeala, Tytti
Anttila, Ahti
author_facet Pankakoski, Maiju
Heinävaara, Sirpa
Sarkeala, Tytti
Anttila, Ahti
author_sort Pankakoski, Maiju
collection PubMed
description OBJECTIVE: Regular screening and follow-up is an important key to cervical cancer prevention; however, screening inevitably detects mild or borderline abnormalities that would never progress to a more severe stage. We analysed the cumulative probability and recurrence of cervical abnormalities in the Finnish organized screening programme during a 22-year follow-up. METHODS: Screening histories were collected for 364,487 women born between 1950 and 1965. Data consisted of 1 207,017 routine screens and 88,143 follow-up screens between 1991 and 2012. Probabilities of cervical abnormalities by age were estimated using logistic regression and generalized estimating equations methodology. RESULTS: The probability of experiencing any abnormality at least once at ages 30–64 was 34.0% (95% confidence interval [CI]: 33.3–34.6%). Probability was 5.4% (95% CI: 5.0–5.8%) for results warranting referral and 2.2% (95% CI: 2.0–2.4%) for results with histologically confirmed findings. Previous occurrences were associated with an increased risk of detecting new ones, specifically in older women. CONCLUSION: A considerable proportion of women experience at least one abnormal screening result during their lifetime, and yet very few eventually develop an actual precancerous lesion. Re-evaluation of diagnostic criteria concerning mild abnormalities might improve the balance of harms and benefits of screening. Special monitoring of women with recurrent abnormalities especially at older ages may also be needed.
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spelling pubmed-56616992017-11-21 High lifetime probability of screen-detected cervical abnormalities Pankakoski, Maiju Heinävaara, Sirpa Sarkeala, Tytti Anttila, Ahti J Med Screen Original Articles OBJECTIVE: Regular screening and follow-up is an important key to cervical cancer prevention; however, screening inevitably detects mild or borderline abnormalities that would never progress to a more severe stage. We analysed the cumulative probability and recurrence of cervical abnormalities in the Finnish organized screening programme during a 22-year follow-up. METHODS: Screening histories were collected for 364,487 women born between 1950 and 1965. Data consisted of 1 207,017 routine screens and 88,143 follow-up screens between 1991 and 2012. Probabilities of cervical abnormalities by age were estimated using logistic regression and generalized estimating equations methodology. RESULTS: The probability of experiencing any abnormality at least once at ages 30–64 was 34.0% (95% confidence interval [CI]: 33.3–34.6%). Probability was 5.4% (95% CI: 5.0–5.8%) for results warranting referral and 2.2% (95% CI: 2.0–2.4%) for results with histologically confirmed findings. Previous occurrences were associated with an increased risk of detecting new ones, specifically in older women. CONCLUSION: A considerable proportion of women experience at least one abnormal screening result during their lifetime, and yet very few eventually develop an actual precancerous lesion. Re-evaluation of diagnostic criteria concerning mild abnormalities might improve the balance of harms and benefits of screening. Special monitoring of women with recurrent abnormalities especially at older ages may also be needed. SAGE Publications 2017-01-10 2017-12 /pmc/articles/PMC5661699/ /pubmed/28073308 http://dx.doi.org/10.1177/0969141316685740 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Pankakoski, Maiju
Heinävaara, Sirpa
Sarkeala, Tytti
Anttila, Ahti
High lifetime probability of screen-detected cervical abnormalities
title High lifetime probability of screen-detected cervical abnormalities
title_full High lifetime probability of screen-detected cervical abnormalities
title_fullStr High lifetime probability of screen-detected cervical abnormalities
title_full_unstemmed High lifetime probability of screen-detected cervical abnormalities
title_short High lifetime probability of screen-detected cervical abnormalities
title_sort high lifetime probability of screen-detected cervical abnormalities
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661699/
https://www.ncbi.nlm.nih.gov/pubmed/28073308
http://dx.doi.org/10.1177/0969141316685740
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